Provider Demographics
NPI:1841657822
Name:CGS PHARMACY LLC
Entity type:Organization
Organization Name:CGS PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SAWSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AL JANABE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-430-2501
Mailing Address - Street 1:PO BOX 2269
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20847-2269
Mailing Address - Country:US
Mailing Address - Phone:240-430-2501
Mailing Address - Fax:240-387-5659
Practice Address - Street 1:202 PERRY PKWY STE 1
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2172
Practice Address - Country:US
Practice Address - Phone:240-430-2501
Practice Address - Fax:240-430-2504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-22
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDPW0458333600000X
IL54018922333600000X
ID37653MS333600000X
IN64001845A333600000X
GAPHNR000909333600000X
FLPH28877333600000X
NE1036333600000X
MS14752333600000X
MN264656333600000X
IA4133333600000X
MO2016008987333600000X
HIPMP-1318333600000X
DEA9-0001819333600000X
KS22-10000035.1333600000X
AKPHAO1555333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2157679OtherPK