Provider Demographics
NPI:1679938641
Name:RITEAID
Entity Type:Organization
Organization Name:RITEAID
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMIL
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDZINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-759-4876
Mailing Address - Street 1:609 LUZERNE ST
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18504-2626
Mailing Address - Country:US
Mailing Address - Phone:570-344-4404
Mailing Address - Fax:
Practice Address - Street 1:609 LUZERNE ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18504-2626
Practice Address - Country:US
Practice Address - Phone:570-344-4404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-17
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP449936183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty