Provider Demographics
NPI:1255618385
Name:LABIC PHARMACY SERVICES LLC
Entity type:Organization
Organization Name:LABIC PHARMACY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF CONSULTING PHARMACIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:CHRISTIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNREMI
Authorized Official - Suffix:
Authorized Official - Credentials:BSC RPH
Authorized Official - Phone:443-207-0574
Mailing Address - Street 1:108 AUTOMOTIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-6374
Mailing Address - Country:US
Mailing Address - Phone:443-207-0574
Mailing Address - Fax:
Practice Address - Street 1:108 AUTOMOTIVE BOULEVARD
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921
Practice Address - Country:US
Practice Address - Phone:443-207-0574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-03
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332900000X
PARP045805L333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332900000XSuppliersNon-Pharmacy Dispensing Site