Rite Aid #11706

LBN: Walgreen Co
Rite Aid #11706 is an health care organization with primary practice located at 4101 Five Forks Trickum Rd Sw , Lilburn GA 30047-3129. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty.

Contact Information

Primary practice address
4101 Five Forks Trickum Rd Sw Lilburn GA 30047-3129
Phone:
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Sweeten, Alyssa
Phone: (217) 709-2386

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X PHRE010465 Georgia
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1073037487
LBN Legal business name Walgreen Co
DBA Doing business as Rite Aid #11706
Authorized official Sweeten, Alyssa
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 27th, 2017
Last updated Apr 30th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073037487 NPPES
Georgia Other 1170757 NCPDP
Georgia MEDICAID 00884166A NCPDP

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