Provider Demographics
NPI:1437297009
Name:MED.ONE PHARMACY DBA THURMONT PHARMACY
Entity Type:Organization
Organization Name:MED.ONE PHARMACY DBA THURMONT PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-271-2223
Mailing Address - Street 1:58 WATER ST
Mailing Address - Street 2:
Mailing Address - City:THURMONT
Mailing Address - State:MD
Mailing Address - Zip Code:21788-1912
Mailing Address - Country:US
Mailing Address - Phone:301-271-2223
Mailing Address - Fax:301-271-3008
Practice Address - Street 1:58 WATER ST
Practice Address - Street 2:
Practice Address - City:THURMONT
Practice Address - State:MD
Practice Address - Zip Code:21788-1912
Practice Address - Country:US
Practice Address - Phone:301-271-2223
Practice Address - Fax:301-271-3008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-03
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDPO4716333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2117821OtherNCPDP