Provider Demographics
NPI:1881748747
Name:DRUGS'R'US
Entity type:Organization
Organization Name:DRUGS'R'US
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:STAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ETELIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-220-4377
Mailing Address - Street 1:6821 REISTERSTOWN RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-1431
Mailing Address - Country:US
Mailing Address - Phone:410-358-7557
Mailing Address - Fax:410-358-6880
Practice Address - Street 1:6821 REISTERSTOWN RD
Practice Address - Street 2:SUITE 207
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-1431
Practice Address - Country:US
Practice Address - Phone:410-358-7557
Practice Address - Fax:410-358-6880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30249820333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD905127100Medicaid
MD905127100Medicaid