Provider Demographics
NPI:1568781557
Name:RITE AID
Entity Type:Organization
Organization Name:RITE AID
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANEGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:I
Authorized Official - Last Name:AZZAM
Authorized Official - Suffix:SR
Authorized Official - Credentials:RPH
Authorized Official - Phone:248-373-7700
Mailing Address - Street 1:2480 LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-1921
Mailing Address - Country:US
Mailing Address - Phone:248-373-7700
Mailing Address - Fax:248-373-9312
Practice Address - Street 1:2480 LAPEER RD
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-1921
Practice Address - Country:US
Practice Address - Phone:248-373-7700
Practice Address - Fax:248-373-7931
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RITE AID
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-31
Last Update Date:2010-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302410541183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty