Provider Demographics
NPI:1801186382
Name:RITE AID
Entity Type:Organization
Organization Name:RITE AID
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:NICOLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGELBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-546-7318
Mailing Address - Street 1:7257 FULTON DR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-3816
Mailing Address - Country:US
Mailing Address - Phone:330-833-9797
Mailing Address - Fax:
Practice Address - Street 1:7257 FULTON DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-3816
Practice Address - Country:US
Practice Address - Phone:330-833-9797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-18
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03230721183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty