Provider Demographics
NPI:1568873339
Name:FIRMUS PHARMACY LLC
Entity Type:Organization
Organization Name:FIRMUS PHARMACY LLC
Other - Org Name:FIRMUS PHARMACY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:SATTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-556-5628
Mailing Address - Street 1:10000 VIRGINIA MANOR RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-4201
Mailing Address - Country:US
Mailing Address - Phone:844-347-6871
Mailing Address - Fax:844-347-6870
Practice Address - Street 1:10000 VIRGINIA MANOR RD STE 350
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-4205
Practice Address - Country:US
Practice Address - Phone:844-347-6871
Practice Address - Fax:844-347-6870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-15
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA9-000177333600000X
MDP064113336C0003X
DCNRX00006063336C0003X
LAPHY.007396-NR3336C0003X
NJ28RO001461003336C0003X
VA2140018453336C0003X
OK99-77603336C0003X
NY348423336C0003X
IL54.0201723336C0003X
PANP0006413336C0003X
OHNRP.022664453336C0003X
NVPH036503336C0003X
MS151233336C0003X
FLPH302483336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2146272OtherPK