# LAUREL MAIN STREET PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Main Street Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043968530
- **Authorized official:** ALI H THAKKAR PHARMD (OWNER)
- **Authorized official phone:** (301) 317-3838

## Contact information

- **Practice address:** 667 MAIN ST, LAUREL, MD 20707-4067
- **Practice address phone:** (301) 317-3838
- **Practice address fax:** (301) 317-3637
- **Mailing address:** 667 MAIN ST, LAUREL, MD 20707-4067
- **Mailing address phone:** (301) 317-3838
- **Mailing address fax:** (301) 317-3637

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 03/14/2022
- **Last updated:** 05/20/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 037359100 | — | DC |
| 05 | — | 336716900 | — | MD |
| 05 | — | 443806000 | — | MD |