RITE AID #17121
NPI 1265955264
Pharmacy in Georgetown, SC
- Organization
- Pharmacy
- CLIA Number: 42D2019741
- CLIA Cert. Type: Pharmacy
- CLIA Exp. Date: 03-24-2027
About RITE AID #17121
This page provides the complete NPI Profile along with additional information for Rite Aid #17121, a provider established in Georgetown, South Carolina operating as a Pharmacy. The healthcare provider is registered in the NPI registry with number 1265955264 assigned on July 2017. The practitioner's primary taxonomy code is 333600000X. The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's is doing business as Rite Aid #17121. The authorized official of this NPI record is Mr. Alan Nielsen (Asst. Treasurer)
- NPI
- 1265955264 Verify this NPI
- Provider Legal Name
- WALGREEN CO
- Other Organization Name
- RITE AID #17121
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1801 HIGHMARKET ST GEORGETOWN, SC 29440
- Location Phone
- (217) 709-2386
- Location Fax
- (217) 709-2344
- Mailing Address
- 1901 E VOORHEES ST # MS 790 DANVILLE, IL 61834
- Mailing Phone
- (217) 709-2386
- Mailing Fax
- (217) 709-2344
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 07-21-2017
- Last Update Date
- 07-21-2017
- Code Navigator
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
- Taxonomy Code
- 333600000X
- Type
- Suppliers
- Taxonomy Description
- A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
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) |
|---|---|---|---|---|
| 1 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | |
| 2 | 3336C0003X | Suppliers | Pharmacy |
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
- 42D2019741
- Facility Type
- Pharmacy
- Certificate Effective Date
- March 25, 2025
- Certificate Expiration Date
- March 24, 2027
- Laboratory Director
- TIARA S. THOMAS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Rite Aid #17121 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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Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1265955264, enumerated as an "organization" on July 21, 2017.
The provider is located at 1801 HIGHMARKET ST GEORGETOWN, SC 29440 and the phone number is (217) 709-2386.
Pharmacy with taxonomy code 333600000X.
