Provider Demographics
NPI:1417335803
Name:RITE AID
Entity Type:Organization
Organization Name:RITE AID
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:MENOHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-323-9333
Mailing Address - Street 1:1844 W GRANDVIEW BLVD
Mailing Address - Street 2:APT 102
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-1077
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:163 W 26TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-1803
Practice Address - Country:US
Practice Address - Phone:814-452-4012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP449137183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty