Provider Demographics
NPI:1275822744
Name:RITE AID PHARMACY
Entity Type:Organization
Organization Name:RITE AID PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:SHERRY
Authorized Official - Last Name:BRACEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:804-733-3471
Mailing Address - Street 1:2141 S CRATER RD
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23805-2701
Mailing Address - Country:US
Mailing Address - Phone:804-733-3471
Mailing Address - Fax:804-733-3984
Practice Address - Street 1:2141 S CRATER RD
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-2701
Practice Address - Country:US
Practice Address - Phone:804-733-3471
Practice Address - Fax:804-733-3984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202011049183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty