Provider Demographics
NPI:1215021597
Name:HILLS DRUG STORE
Entity Type:Organization
Organization Name:HILLS DRUG STORE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL SHANNAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:410-819-6541
Mailing Address - Street 1:301 BAY ST STE 203
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-2795
Mailing Address - Country:US
Mailing Address - Phone:410-819-6541
Mailing Address - Fax:
Practice Address - Street 1:503 CYNWOOD DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3869
Practice Address - Country:US
Practice Address - Phone:410-819-6541
Practice Address - Fax:410-819-3170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP00328333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD201032100Medicaid
2110586OtherOTHER ID NUMBER-COMMERCIAL NUMBER