Provider Demographics
NPI:1811970882
Name:RITE AID PHARMACY
Entity type:Organization
Organization Name:RITE AID PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:DENICE
Authorized Official - Last Name:ENLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-772-1050
Mailing Address - Street 1:5240 LOCUST HILL LN
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-4321
Mailing Address - Country:US
Mailing Address - Phone:614-507-9756
Mailing Address - Fax:740-772-6964
Practice Address - Street 1:601 CENTRAL CTR
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-2249
Practice Address - Country:US
Practice Address - Phone:740-772-1050
Practice Address - Fax:740-772-6964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-10920183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03-1-10920OtherSTATE LISCENCE NUMBER