Provider Demographics
NPI:1134439292
Name:RITE AID 11333
Entity type:Organization
Organization Name:RITE AID 11333
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:PRAHLAD
Authorized Official - Middle Name:
Authorized Official - Last Name:PRAJAPATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-869-3353
Mailing Address - Street 1:2012 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-2134
Mailing Address - Country:US
Mailing Address - Phone:336-882-0039
Mailing Address - Fax:
Practice Address - Street 1:2012 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-2134
Practice Address - Country:US
Practice Address - Phone:336-882-0039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-07
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC073763336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy