Provider Demographics
NPI:1619907623
Name:T B PHARMACEUTICALS INC
Entity Type:Organization
Organization Name:T B PHARMACEUTICALS INC
Other - Org Name:THE MEDICINE SHOPPE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RPH OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHANAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-722-5100
Mailing Address - Street 1:1100 W INDUSTRIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-4412
Mailing Address - Country:US
Mailing Address - Phone:301-722-5100
Mailing Address - Fax:301-724-0224
Practice Address - Street 1:1100 W INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-4412
Practice Address - Country:US
Practice Address - Phone:301-722-5100
Practice Address - Fax:301-724-0224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MDP013743336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2034221OtherPK
MD008386100Medicaid
WV600134600Medicaid
MD482442300Medicaid
MD008386100Medicaid