Provider Demographics
NPI:1497236343
Name:BEDFORD ROAD PHARMACY, INC.
Entity Type:Organization
Organization Name:BEDFORD ROAD PHARMACY, INC.
Other - Org Name:PHARMACARE SOUTH CUMBERLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:CORWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-777-1773
Mailing Address - Street 1:3 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-1058
Mailing Address - Country:US
Mailing Address - Phone:301-723-2423
Mailing Address - Fax:301-723-2211
Practice Address - Street 1:1100 W INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-4460
Practice Address - Country:US
Practice Address - Phone:301-722-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEDFORD ROAD PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy