Provider Demographics
NPI:1841599008
Name:THRIFTY RITE AID CORPORATION
Entity Type:Organization
Organization Name:THRIFTY RITE AID CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTAGNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-948-0950
Mailing Address - Street 1:5260 HILDRETH LN
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-2320
Mailing Address - Country:US
Mailing Address - Phone:209-948-0650
Mailing Address - Fax:
Practice Address - Street 1:1050 N WILSON WAY
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95205-4218
Practice Address - Country:US
Practice Address - Phone:209-948-0950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-26
Last Update Date:2011-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43978261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service