RITE AID OF PENNSYLVANIA LLC (NPI# 1306936323) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306936323 |
| Entity Type | Organization |
| Organization Name | RITE AID OF PENNSYLVANIA LLC |
| Other Organization Name | RITE AID PHARMACY 04791 |
| Practice Address |
2023 Lycoming Creek Road Williamsport PA 17701-1206 |
| Mailing Address |
200 Newberry Commons Etters PA 17319-9363 |
| Practice Telephone | 5703279920 |
| Mailing Telephone | 7177612633 |
| Mailing Fax Number | 7179758659 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-06-24 |
| Authorized Official Name | JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION) |
| Authorized Official Telephone | 7179755937 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PP414514L | PA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | MEDICAID DME | 1007292981075 | 01 |
| PA | 1007292981075 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 3972773 | 01 |
| Other Name | Type Code |
|---|---|
| RITE AID PHARMACY 04791 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396236733 | Rite Aid of Pennsylvania LLC | Durable Medical Equipment & Medical Supplies | 503 Clifton Rd, Bethel Park, PA 15102-1341 | 2018-05-22 |
| 1285009100 | Rite Aid of Pennsylvania LLC | Durable Medical Equipment & Medical Supplies | 1900 Arch Street, Philadelphia, PA 19103-1305 | 2015-12-03 |
| 1346621802 | Rite Aid of Pennsylvania LLC | Durable Medical Equipment & Medical Supplies | 100 Forbes Avenue, Suite 100, Pittsburgh, PA 15233-1234 | 2015-06-10 |
| 1720489081 | Rite Aid of Pennsylvania LLC | Durable Medical Equipment & Medical Supplies | 94 June Drive, Roaring Spring, PA 16673 | 2014-09-05 |
| 1922409283 | Rite Aid of Pennsylvania LLC | Durable Medical Equipment & Medical Supplies | 1600 9th Avenue, Altoona, PA 16602 | 2014-09-05 |
| 1821499187 | Rite Aid of Pennsylvania LLC | Durable Medical Equipment & Medical Supplies | 1201 Blair Street, Hollidaysburg, PA 16648 | 2014-09-05 |
| 1548660129 | Rite Aid of Pennsylvania LLC | Durable Medical Equipment & Medical Supplies | 1365 Logan Avenue, Tyrone, PA 16686 | 2014-09-02 |
| 1629245436 | Rite Aid of Pennsylvania LLC | Durable Medical Equipment & Medical Supplies | 2108 Macarthur Road, Whitehall, PA 18052-4520 | 2008-05-12 |
| 1205009941 | Rite Aid of Pennsylvania LLC | Durable Medical Equipment & Medical Supplies | 3145 Main Street, Morgantown, PA 19543 | 2008-04-02 |
| 1184894180 | Rite Aid of Pennsylvania LLC | Durable Medical Equipment & Medical Supplies | 9200 Frankford Avenue, Philadelphia, PA 19114 | 2008-03-05 |
| Street Address |
2023 LYCOMING CREEK ROAD |
| City | WILLIAMSPORT |
| State | PA |
| Zip Code | 17701-1206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184267809 | Charlene Angella Pitter | Nurse Practitioner | 170 Warren Ave, Williamsport, PA 17701 | 2019-10-25 |
| 1396395299 | Susan E Fetzer | Occupational Therapy Assistant | Upmc Susquehanna,625 West Edwin Street, Williamsport, PA 17701 | 2019-09-13 |
| 1184280984 | Craig Andrew Tuller | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency, 740 High Street, Suite 4001, Williamsport, PA 17701 | 2019-05-16 |
| 1760048045 | Michael Harvey | Student in an Organized Health Care Education/Training Program | 740 High St. Suite 4001, Williamsport, PA 17701 | 2019-05-13 |
| 1275196008 | Olivia Fladmark | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency 740 High St, Suite 4001, Williamsport, PA 17701 | 2019-04-17 |
| 1528551231 | Mark Hampton Chiropractic Inc. | Durable Medical Equipment & Medical Supplies | 1111 East 3rd Street, Williamsport, PA 17701 | 2018-06-08 |
| 1548710882 | Central Pennsylvania Rehabilitation Medicine, Inc | Physical Medicine & Rehabilitation | 460 River Ave Ste 1, Williamsport, PA 17701 | 2016-10-11 |
| 1376096784 | Christine Kessler | Physician Assistant | One College Ave, Penna. College of Tech, Pa Program Dif 123, Williamsport, PA 17701 | 2016-08-02 |
| 1629440276 | Matthew Ray Rebuck | Specialist/Technologist | 220 N Reach Rd, Williamsport, PA 17701 | 2015-10-22 |
| 1508237223 | Neihl Williamson | Physician Assistant | 1205 Grampian Blvd Ste 3c, Williamsport, PA 17701 | 2015-10-08 |
| Find all providers in zip 17701 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154493948 | Saved By Grace Inc | Pharmacy | 507 Hepburn St, Williamsport, PA 17701-5004 | 2006-11-15 |
| 1104915321 | Antietam Health Services | Pharmacy | 307 E Potomac Street, Williamsport, MD 21795-1203 | 2006-10-12 |
| 1366530057 | Penbec Inc | Pharmacy | 34 N Conococheague St, Williamsport, MD 21795-1004 | 2006-10-10 |
| 1396765269 | Pharmacpo 2 Inc | Pharmacy | 1009 Washington Blvd, Williamsport, PA 17701-3633 | 2006-07-20 |
| 1386106680 | Susquehanna Community Health and Dental Clinic, Inc | Pharmacy | 471 Hepburn St, Williamsport, PA 17701-6122 | 2019-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376143990 | Valerie Hellriegel | Pharmacy | 567 N Route 100, Bechtelsville, PA 19505-9263 | 2020-11-01 |
| 1134729791 | John P Russo | Pharmacy | 608 E Hillcrest Ave, New Castle, PA 16105-2254 | 2020-10-31 |
| 1538769864 | Luzerne Discount Pharmacy Inc | Pharmacy | 101 Main St Unit D, Luzerne, PA 18709-1209 | 2020-10-27 |
| 1417555616 | Dubois Regional Medical Center | Pharmacy | 265 Holiday Inn Drive Route 68, Clarion, PA 16214 | 2020-10-12 |
| 1780290197 | Weis Markets, Inc. | Pharmacy | 112 Atlantic Ave., Dingmans Ferry, PA 18328 | 2020-09-21 |
| 1275146177 | Newport Pharmacy LLC | Pharmacy | 57 S 2nd St, Newport, PA 17074-1402 | 2020-08-28 |
| 1699387779 | Allegheny Valley Hospital Retail Pharmacy | Pharmacy | 1301 Carlisle St Fl 3, Natrona Heights, PA 15065-1152 | 2020-08-19 |
| 1396355426 | Mdk Health | Pharmacy | 3985 Columbia Ave Unit 2, Columbia, PA 17512-9003 | 2020-08-04 |
| 1861000861 | Koso,llc | Pharmacy | 407 Shadeland Ave, Drexel Hill, PA 19026-1437 | 2020-07-16 |
| 1184241408 | Roosevelt Pharmacy LLC | Pharmacy | 2600 Cottman Ave, Philadelphia, PA 19149-1301 | 2020-07-02 |
| Find all providers with the same taxonomy | ||||
| City | WILLIAMSPORT |
| Zip Code | 17701 |
Please comment or provide details below to improve the information on RITE AID OF PENNSYLVANIA LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.