Provider Demographics
NPI:1073607487
Name:LAWSONS PHARMACY INC
Entity Type:Organization
Organization Name:LAWSONS PHARMACY INC
Other - Org Name:LAWSONS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SABATELLI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:301-864-4043
Mailing Address - Street 1:3415 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3953
Mailing Address - Country:US
Mailing Address - Phone:301-864-4043
Mailing Address - Fax:301-864-5548
Practice Address - Street 1:3415 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-3953
Practice Address - Country:US
Practice Address - Phone:301-864-4043
Practice Address - Fax:301-864-5548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD016652900Medicaid
2112629OtherOTHER ID NUMBER-COMMERCIAL NUMBER