Provider Demographics
NPI:1578951273
Name:RITE AID
Entity Type:Organization
Organization Name:RITE AID
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TAHAR
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:LOMRI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:610-209-6310
Mailing Address - Street 1:1825 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-4925
Mailing Address - Country:US
Mailing Address - Phone:252-535-4681
Mailing Address - Fax:
Practice Address - Street 1:1825 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-4925
Practice Address - Country:US
Practice Address - Phone:252-535-4681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-03
Last Update Date:2015-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23625183500000X
PARP439787183500000X
NY044158183500000X
333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No333600000XSuppliersPharmacyGroup - Multi-Specialty