Organization
MILFORD STREET PHARMACY LLC
Active
Organization
MILFORD STREET PHARMACY LLC
Active
Other names
MILFORD STREET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SANJAY L RAYATHATHA (MEMBER/OWNER)
(410) 860-0700
Entity
Organization
Contact information
Practice address
106 MILFORD ST, SUITE 401, SALISBURY, MD 21804-6953
(410) 860-0700
(410) 860-0079
Mailing address
106 MILFORD ST, SUITE 401, SALISBURY, MD 21804
(410) 860-0700
(410) 860-0079
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2037547
PK
—
05
—
401150300
—
MD
05
—
402581400
—
MD
05
—
501304600
—
MD
Enumeration date
09/20/2006
Last updated
04/03/2020
Update your record
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