Provider Demographics
NPI:1619276870
Name:MEDLEY, ALETHIA
Entity Type:Individual
Prefix:
First Name:ALETHIA
Middle Name:
Last Name:MEDLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 N DUPONT HWY
Mailing Address - Street 2:C/O RITE AID
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-7509
Mailing Address - Country:US
Mailing Address - Phone:302-674-2945
Mailing Address - Fax:
Practice Address - Street 1:245 N DUPONT HWY
Practice Address - Street 2:C/O RITE AID
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-7509
Practice Address - Country:US
Practice Address - Phone:302-674-2945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-26
Last Update Date:2011-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0004134183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist