Provider Demographics
NPI:1649599705
Name:RITEAID PHARMACY
Entity Type:Organization
Organization Name:RITEAID PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:GEETHA
Authorized Official - Middle Name:SAROJINI
Authorized Official - Last Name:GADIRAJU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-356-8301
Mailing Address - Street 1:1312 CHAIN BRIDGE RD
Mailing Address - Street 2:STORE 3723
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3966
Mailing Address - Country:US
Mailing Address - Phone:703-356-5822
Mailing Address - Fax:
Practice Address - Street 1:1312 CHAIN BRIDGE RD
Practice Address - Street 2:STORE 3723
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3966
Practice Address - Country:US
Practice Address - Phone:703-356-5822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207739183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty