Provider Demographics
NPI:1245278951
Name:MARYLAND PHARMACIES INC
Entity type:Organization
Organization Name:MARYLAND PHARMACIES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SEKAR
Authorized Official - Middle Name:B
Authorized Official - Last Name:VENKATESH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-681-5878
Mailing Address - Street 1:10313 GEORGIA AVE
Mailing Address - Street 2:SUITE # 101
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-5006
Mailing Address - Country:US
Mailing Address - Phone:301-681-5878
Mailing Address - Fax:301-681-5962
Practice Address - Street 1:10313 GEORGIA AVE
Practice Address - Street 2:SUITE # 101
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5006
Practice Address - Country:US
Practice Address - Phone:301-681-5878
Practice Address - Fax:301-681-5962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP010503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD510318500Medicaid