Provider Demographics
NPI:1851974646
Name:MEDSPACK MD LLC
Entity Type:Organization
Organization Name:MEDSPACK MD LLC
Other - Org Name:FOERS LTC PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PRAMOD
Authorized Official - Middle Name:
Authorized Official - Last Name:ARIKERI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:301-216-1190
Mailing Address - Street 1:5006 E TRINDLE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-3647
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1300 PICCARD DR
Practice Address - Street 2:STE LL#16
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850
Practice Address - Country:US
Practice Address - Phone:301-216-1190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-30
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy