Provider Demographics
NPI:1043596513
Name:S & R REISTERSTOWN LLC
Entity Type:Organization
Organization Name:S & R REISTERSTOWN LLC
Other - Org Name:NATURECARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:SYAM
Authorized Official - Middle Name:K
Authorized Official - Last Name:POTLURI
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:443-823-3350
Mailing Address - Street 1:2 HUNTFIELD CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1506
Mailing Address - Country:US
Mailing Address - Phone:410-833-9844
Mailing Address - Fax:410-833-9845
Practice Address - Street 1:40 MAIN STREET
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136
Practice Address - Country:US
Practice Address - Phone:410-833-9844
Practice Address - Fax:410-833-9845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-28
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy