RITE AID PHARMACY 05421
NPI 1235248774
Pharmacy - Community/Retail Pharmacy in Moscow, ID

NPI Status: Active since August 29, 2006

Contact Information

1810 WEST PULLMAN ROAD
PALOUSE EMPIRE MALL
MOSCOW, ID
ZIP 83843
Phone: (208) 882-3583

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  • Organization
  • Pharmacy
  • Community/Retail Pharmacy
  • Accepts Insurance
  • Medicare Supplier
  • Accepts Medicare Approved Payment
  • CLIA Number: 13D2126015
  • CLIA Cert. Type: Pharmacy
  • CLIA Exp. Date: 02-16-2027

About RITE AID PHARMACY 05421

This page provides the complete NPI Profile along with additional information for Rite Aid Pharmacy 05421, a provider established in Moscow, Idaho operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1235248774 assigned on August 2006. The practitioner's primary taxonomy code is 3336C0003X with license number ID1220CP (ID). The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's is doing business as Rite Aid Pharmacy 05421. The authorized official of this NPI record is Jennifer Zorek (Manager Online Adjudication)

NPI
1235248774
Provider Legal Name
THRIFTY PAYLESS INC
Other Organization Name
RITE AID PHARMACY 05421
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1810 WEST PULLMAN ROAD PALOUSE EMPIRE MALL MOSCOW, ID 83843
Location Phone
(208) 882-3583
Mailing Address
200 NEWBERRY COMMONS ETTERS, PA 17319
Mailing Phone
(717) 761-2633
Mailing Fax
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-29-2006
Last Update Date
04-04-2023
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Rite Aid Pharmacy 05421 is a medicare supplier with PTAN 20537153 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Epoetin or Immunosuppressive Drugs or Infusion Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or Commodes, Urinals, Bedpans or Blood Glucose Monitors/Supplies (Non-Mail Order) or Blood Glucose Monitors/Supplies (Mail Order) or Heat & Cold Applications or Canes and/or Crutches or Walkers or Ostomy Supplies or Urological Supplies or Surgical Dressings.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pharmacy Community/Retail Pharmacy

Taxonomy Code
3336C0003X
Type
Suppliers
License No.
ID1220CP
License State
ID
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1291U00000XLaboratories

Clinical Medical Laboratory

 
2332B00000XSuppliers

Durable Medical Equipment & Medical Supplies

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Humana Dental Smart Choice - PPO
  • Humana Dental Smart Choice - High - PPO
  • Humana Dental Smart Choice - Lite - PPO
  • Humana Dental Smart Choice - Low - PPO
  • Balance by Medica Bronze $0 Copay PCP Visits - EPO
  • Balance by Medica Bronze $0 Copay PCP Visits - PPO
  • Balance by Medica Bronze Premier - EPO
  • Balance by Medica Bronze Premier - PPO
  • Balance by Medica Expanded Bronze Standard - EPO
  • Balance by Medica Expanded Bronze Standard - PPO
  • Balance by Medica Gold $0 Copay PCP Visits - EPO
  • Balance by Medica Gold $0 Copay PCP Visits - PPO
  • Balance by Medica Gold Share - EPO
  • Balance by Medica Gold Share - PPO
  • Balance by Medica Gold Standard - EPO
  • Balance by Medica Gold Standard - PPO
  • Balance by Medica Silver $0 Copay PCP Visits - EPO
  • Balance by Medica Silver $0 Copay PCP Visits - PPO
  • Balance by Medica Silver Share - EPO
  • Balance by Medica Silver Share - PPO
  • Balance by Medica Silver Standard - EPO
  • Balance by Medica Silver Standard - PPO
  • Elevate by Medica Bronze $0 Copay PCP Visits - EPO
  • Elevate by Medica Bronze Premier - EPO
  • Moda Health Affinity Bronze 8000 - EPO
  • Moda Health Affinity Bronze 9000 - EPO
  • Moda Health Affinity Bronze HDHP 7500 - EPO
  • Moda Health Affinity Gold 1000 - EPO
  • Moda Health Affinity Gold 1500 - EPO
  • Moda Health Affinity Gold 250 - EPO
  • Moda Health Affinity Silver 3000 - EPO
  • Moda Health Affinity Silver 3400 - EPO
  • Moda Health Affinity Silver 4500 - EPO
  • Moda Health Affinity Silver 6000 - EPO
  • Moda Health Oregon Standard Bronze Affinity - EPO
  • Moda Health Oregon Standard Gold Affinity - EPO
  • Moda Health Oregon Standard Silver Affinity - EPO
  • Moda Select Alaska Bronze 6500 - PPO
  • Moda Select Alaska Bronze HDHP 5500 - PPO
  • Moda Select Alaska Gold 1500 - PPO
  • Moda Select Alaska Silver 4500 - PPO
  • Moda Select Alaska Standard Bronze - PPO
  • Moda Select Alaska Standard Gold - PPO
  • Moda Select Alaska Standard Silver - PPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JENNIFER ZOREK

Authorized Official Title
MANAGER ONLINE ADJUDICATION
Authorized Official Phone
(717) 975-5937

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
6011530MEDICAID (05)WA 
1305451OTHER (01)OTHER ID NUMBER-COMMERCIAL NUMBER
804029200MEDICAID (05)ID 
6011530OTHER (01)WAMEDICAID DME

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Adm sarscov2 30mcg/0.3ml 3rd

This refers to the administration of a 30 microgram dose of a SARS-CoV-2 vaccine in a 0.3 milliliter volume. It's the third dose, often referred to as a booster shot, which helps to strengthen your body's immune response against the COVID-19 virus.

This service was performed 12 times for 12 patients

Adm sarscov2 50mcg/0.25mlbst

This procedure involves administering a dose of a SARS-CoV-2 vaccine. The specific dosage is 50 micrograms in a 0.25 milliliter booster shot. This vaccine helps your body build immunity against the COVID-19 virus. It's a key part of global efforts to control the pandemic.

This service was performed 182 times for 181 patients

Adm sarscv2 30mcg trs-sucr b

This service involves the administration of a 30mcg dose of the SARS-CoV-2 vaccine, which helps protect against COVID-19. The 'trs-sucr b' indicates it's stabilized with sugars for effectiveness. It's a crucial step in maintaining your health during the pandemic.

This service was performed 214 times for 214 patients

Administration of influenza virus vaccine

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

This service was performed 521 times for 519 patients

Administration of pneumococcal vaccine

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

This service was performed 30 times for 30 patients

Fee covid-19 vac 13 res

The "Fee Covid-19 Vac 13 Res" service refers to a charge for the 13th dose of the Covid-19 vaccine, typically for individuals requiring additional doses due to specific health conditions. It's crucial to follow your healthcare provider's advice for your health safety.

This service was performed 413 times for 412 patients

Fee covid-19 vac 14 res

The "Fee covid-19 vac 14 res" refers to a charge for a specific service related to the COVID-19 vaccine. This could be for administering the vaccine or related care. It's crucial to get vaccinated to protect against the virus. The fee ensures quality service.

This service was performed 87 times for 87 patients

Influenza vaccine split virus, preservative free

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

This service was performed 90 times for 90 patients

Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free

The quadrivalent influenza vaccine is a flu shot that protects against four different flu viruses. Derived from cell cultures, it is free of preservatives and antibiotics. It's a safe and effective way to reduce your risk of getting the flu.

This service was performed 12 times for 12 patients

Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage

The quadrivalent inactivated influenza vaccine is a shot given to protect against four strains of the flu virus. This 0.5 ml dosage helps your body develop immunity to the virus. It's an important step in preventing flu-related complications.

This service was performed 393 times for 393 patients

Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage

The quadrivalent influenza vaccine is a shot to protect you from four different flu viruses. It's preservative-free and given in a 0.5 ml dose. It helps your body build immunity to the flu, reducing your risk of getting sick.

This service was performed 17 times for 17 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

This service was performed 20 times for 20 patients

Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count

This service provides a FDA-approved COVID-19 test kit for personal use. The test is self-administered and self-collected, meaning you conduct the test yourself. The kit contains all necessary items for one test. Follow the instructions carefully to ensure accurate results.

This service was performed 816 times for 102 patients

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20537153
Accepts Medicare Assignment
YES
Specialities List
Pharmacy.
Competitive Bidding
NO

Supplies List

  • Epoetin - Epoetin is a man-made version of human erythropoietin (EPO)
  • Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
  • Infusion Drugs -
  • Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
  • Oral Anticancer Drugs - FDA anticancer drugs
  • Oral Antiemetic Drugs - FDA antiemetic drugs
  • Commodes, Urinals, Bedpans - Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
  • Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
  • Blood Glucose Monitors/Supplies (Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
  • Heat & Cold Applications - Heat therapy, Cold therapy, Heating pads
  • Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
  • Walkers - Standard Walkers, Wheeled Walkers, Folding Walker
  • Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
  • Urological Supplies - Catheters, Urinary collection devices
  • Surgical Dressings - Gauze, Elastic bandages, Adhesive tape

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
13D2126015
Facility Type
Pharmacy
Certificate Effective Date
February 17, 2025
Certificate Expiration Date
February 16, 2027
Laboratory Director
JOSEPH CASTELLANO
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Rite Aid Pharmacy 05421 to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1235248774, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
3
Doubled → 6
Pos 4
5
Unchanged
Pos 5
2
Doubled → 4
Pos 6
4
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
7
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 2 → 4 8 → 16 → 7 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 6 + 5 + 4 + 4 + 1 + 6 + 7 + 1 + 4 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1235248774.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1235248774, enumerated as an "organization" on August 29, 2006.

The provider is located at 1810 WEST PULLMAN ROAD PALOUSE EMPIRE MALL MOSCOW, ID 83843 and the phone number is (208) 882-3583.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

The provider might be accepting Accepts: Humana, Medica, Moda Health Plan, Inc., Medicare. Please consult your insurance carrier or call the provider to verify.