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Organization
CENTREVILLE DRUGS INC
Active
Organization
CENTREVILLE DRUGS INC
Active
Other names
EDWARDS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SHALENDRA CHERUKURI RPH (VICE PRESIDENT)
(410) 758-1715
Entity
Organization
Contact information
Practice address
102 COMMERCE STREET, CENTREVILLE, MD 21617
(410) 758-1715
(410) 758-3112
Mailing address
102 S COMMERCE ST, CENTREVILLE, MD 21617-1116
(410) 758-1715
(410) 758-1714
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
P04614
MD
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013917300
—
MD
01
—
2104913
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/21/2006
Last updated
01/18/2019
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