Provider Demographics
NPI:1619420361
Name:RITE AID CORPORATION
Entity Type:Organization
Organization Name:RITE AID CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BORI
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:267-608-5000
Mailing Address - Street 1:301 BYBERRY RD
Mailing Address - Street 2:ST. E11
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-1947
Mailing Address - Country:US
Mailing Address - Phone:267-608-5000
Mailing Address - Fax:
Practice Address - Street 1:4616 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-1218
Practice Address - Country:US
Practice Address - Phone:215-329-4840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service