Organization
LAXMI DURGA RX LLC
Active
Other names
edmondson pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PRUDVI RAM REDDY PEDAVEETI (PHARMACY MANAGER)
(410) 566-5565
Entity
Organization
Contact information
Practice address
4506 EDMONDSON AVE, BALTIMORE, MD 21229-1506
(410) 566-5565
(410) 566-1969
Mailing address
4506 EDMONDSON AVE, BALTIMORE, MD 21229-1506
(410) 566-5565
(410) 566-1969
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
P05769
MD
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
10/18/2012
Last updated
05/24/2021
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