Provider Demographics
NPI:1598299174
Name:RITE AID PHARMACY
Entity type:Organization
Organization Name:RITE AID PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:COLLETTE
Authorized Official - Middle Name:CHINWE
Authorized Official - Last Name:ONYEJEKWE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, RPH
Authorized Official - Phone:401-999-0630
Mailing Address - Street 1:711 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02907-1481
Mailing Address - Country:US
Mailing Address - Phone:401-331-9550
Mailing Address - Fax:
Practice Address - Street 1:711 BROAD ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02907-1481
Practice Address - Country:US
Practice Address - Phone:401-331-9550
Practice Address - Fax:401-272-7634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH057013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy