Provider Demographics
NPI:1790210789
Name:RITE AID
Entity Type:Organization
Organization Name:RITE AID
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BHARGHAVI DEVI
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNDARAPU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-425-9257
Mailing Address - Street 1:3601 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-2526
Mailing Address - Country:US
Mailing Address - Phone:717-545-8183
Mailing Address - Fax:
Practice Address - Street 1:3601 WALNUT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-2526
Practice Address - Country:US
Practice Address - Phone:717-545-8183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-27
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP451324183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty