Provider Demographics
NPI:1225407182
Name:TRUECARE PHARMACY INC
Entity Type:Organization
Organization Name:TRUECARE PHARMACY INC
Other - Org Name:TRUE CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLADSON
Authorized Official - Middle Name:
Authorized Official - Last Name:NWANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-419-9833
Mailing Address - Street 1:PO BOX 32694
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21282-2694
Mailing Address - Country:US
Mailing Address - Phone:410-419-9833
Mailing Address - Fax:410-254-0400
Practice Address - Street 1:5950 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-2615
Practice Address - Country:US
Practice Address - Phone:410-254-0100
Practice Address - Fax:410-254-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MDP069343336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2154205OtherPK