Provider Demographics
NPI:1851585467
Name:NOORI L.L.C.
Entity Type:Organization
Organization Name:NOORI L.L.C.
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:RIZWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:410-789-8722
Mailing Address - Street 1:5507 RITCHIE HWY STE A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21225-3472
Mailing Address - Country:US
Mailing Address - Phone:410-789-8722
Mailing Address - Fax:410-789-2165
Practice Address - Street 1:5507 RITCHIE HWY STE A
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MD
Practice Address - Zip Code:21225-3472
Practice Address - Country:US
Practice Address - Phone:410-789-8722
Practice Address - Fax:410-789-2165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD017905100Medicaid
MD015476800Medicaid
MD2133522OtherNCPDP #
MD2133522OtherNCPDP #
MD2133522OtherNCPDP #