1326147588 NPI number — THRIFT DRUG INC

Table of content: (NPI 1326147588)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326147588 NPI number — THRIFT DRUG INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THRIFT DRUG INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
RITE AID PHARMACY 10890
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326147588
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/21/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 NEWBERRY COMMONS
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ETTERS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17319-9363
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-761-2633
Provider Business Mailing Address Fax Number:
717-975-8659

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1505 7TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEAVER FALLS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15010-4121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-843-6774
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ZOREK
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
M
Authorized Official Title or Position:
SR MANAGER THIRD PARTY ENROLLMENTS
Authorized Official Telephone Number:
717-975-5937

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PP413850L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 07287460177 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1242650 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007287460177 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2586214 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3962568 . This is a "NCPDP" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com