Organization
S & R PHARMACY LLC
Active
Other names
FULLER MEDICAL CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SYAM POTLURI B.PHARM (PHARMACY MANAGER)
(410) 574-1440
Entity
Organization
Contact information
Practice address
6918 RIDGE RD, BALTIMORE, MD 21237-3854
(410) 574-1440
(410) 574-1970
Mailing address
6918 RIDGE RD, BALTIMORE, MD 21237-3854
(410) 574-1440
(410) 574-1970
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P05823
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138118
PK
—
Enumeration date
11/28/2006
Last updated
06/17/2022
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