Provider Demographics
NPI:1205834579
Name:ALCO PHARMACEUTICALS, INC
Entity Type:Organization
Organization Name:ALCO PHARMACEUTICALS, INC
Other - Org Name:ALCO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:DENRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-394-7300
Mailing Address - Street 1:11435 CRONHILL DR STE A
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-2220
Mailing Address - Country:US
Mailing Address - Phone:443-394-7300
Mailing Address - Fax:443-394-6770
Practice Address - Street 1:11435 CRONHILL DR STE A
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-2220
Practice Address - Country:US
Practice Address - Phone:443-394-7300
Practice Address - Fax:443-394-6770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MDPW02493336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA008502471Medicaid
DC026839700Medicaid
2036169OtherPK
MD411267900Medicaid
DE000811107Medicaid
PA01647800Medicaid
1249240001Medicare NSC