Provider Demographics
NPI:1053331843
Name:HOME CARE PHARMACY ROBINWOOD
Entity Type:Organization
Organization Name:HOME CARE PHARMACY ROBINWOOD
Other - Org Name:ANTIETAM HEALTH SERVICES, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ZAMPELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-665-4510
Mailing Address - Street 1:11110 MEDICAL CAMPUS RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-6700
Mailing Address - Country:US
Mailing Address - Phone:301-714-4000
Mailing Address - Fax:301-714-4015
Practice Address - Street 1:11110 MEDICAL CAMPUS RD
Practice Address - Street 2:SUITE 105
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6700
Practice Address - Country:US
Practice Address - Phone:301-714-4000
Practice Address - Fax:301-714-4015
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANTIETAM HEALTH SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-21
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP01789183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2119192OtherNABP/NCPDP
MD0391030006Medicare NSC