Provider Demographics
NPI:1376155713
Name:TURK, JAIRUS LAQUINTEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAIRUS
Middle Name:LAQUINTEN
Last Name:TURK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 FALMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-3347
Mailing Address - Country:US
Mailing Address - Phone:251-648-6765
Mailing Address - Fax:
Practice Address - Street 1:6260 CRAIN HWY
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-4258
Practice Address - Country:US
Practice Address - Phone:301-934-9564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-18
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27296183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD19190840Medicaid