Organization
LAUREL PHARMACY II LLC
Active
Other names
LAUREL PHARMACY Rt 1
Organization subpart
No
Provider details
NPI number
Authorized official
EJIKE UNEGUBU (PHARMACY MANAGER)
(301) 604-8500
Entity
Organization
Contact information
Practice address
14402 BALTIMORE AVE, LAUREL, MD 20707
(301) 604-4455
(301) 238-7455
Mailing address
14402 BALTIMORE AVE, LAUREL, MD 20707-4953
(301) 604-4455
(240) 539-6004
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07723
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2177245
PK
—
Enumeration date
05/01/2018
Last updated
07/30/2018
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