Provider Demographics
NPI:1750795050
Name:RITE AID PHARMACY
Entity type:Organization
Organization Name:RITE AID PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DISTRICT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SNEDEKER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:570-394-3051
Mailing Address - Street 1:148 ENNIS LN
Mailing Address - Street 2:
Mailing Address - City:TOWANDA
Mailing Address - State:PA
Mailing Address - Zip Code:18848-9198
Mailing Address - Country:US
Mailing Address - Phone:570-265-4769
Mailing Address - Fax:570-265-8012
Practice Address - Street 1:148 ENNIS LN
Practice Address - Street 2:
Practice Address - City:TOWANDA
Practice Address - State:PA
Practice Address - Zip Code:18848-9198
Practice Address - Country:US
Practice Address - Phone:570-265-4769
Practice Address - Fax:570-265-8012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP446431183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty