Provider Demographics
NPI:1114379138
Name:RITE AID
Entity Type:Organization
Organization Name:RITE AID
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DISTRICT MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN-MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEYNBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-749-3750
Mailing Address - Street 1:1077 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-2504
Mailing Address - Country:US
Mailing Address - Phone:803-778-6551
Mailing Address - Fax:
Practice Address - Street 1:1077 BROAD ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-2504
Practice Address - Country:US
Practice Address - Phone:803-778-6551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-02
Last Update Date:2016-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC366193336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy