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Organization
LAUREL MAIN STREET PHARMACY
Active
Organization
LAUREL MAIN STREET PHARMACY
Active
Other names
Main Street Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ALI H THAKKAR PHARMD (OWNER)
(301) 317-3838
Entity
Organization
Contact information
Practice address
667 MAIN ST, LAUREL, MD 20707-4067
(301) 317-3838
(301) 317-3637
Mailing address
667 MAIN ST, LAUREL, MD 20707-4067
(301) 317-3838
(301) 317-3637
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
NULL
3336C0002X
Clinic Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
—
NULL
3336C0004X
Compounding Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037359100
—
DC
05
—
336716900
—
MD
05
—
443806000
—
MD
Enumeration date
03/14/2022
Last updated
05/20/2025
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