Provider Demographics
NPI:1528468287
Name:RITE AID
Entity type:Organization
Organization Name:RITE AID
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:MAURINO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:805-975-7547
Mailing Address - Street 1:294 W PALO ALTO AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-0285
Mailing Address - Country:US
Mailing Address - Phone:805-975-7547
Mailing Address - Fax:
Practice Address - Street 1:294 W PALO ALTO AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-0285
Practice Address - Country:US
Practice Address - Phone:805-975-7547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-01
Last Update Date:2014-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35354282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren