Organization
KLC PHARMACY
Active
Other names
MEDMERICA LONG TERM CARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
AJAY KHANNA (PRESIDENT)
(443) 552-5553
Entity
Organization
Contact information
Practice address
5602 BALTIMORE NATIONAL PIKE, STE 100, BALTIMORE, MD 21228-1411
(443) 552-5553
(443) 955-6082
Mailing address
5602 BALTIMORE NATIONAL PIKE, STE 100, BALTIMORE, MD 21228-1411
(443) 552-5553
(443) 955-6082
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
P05519
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2135324
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/03/2010
Last updated
08/08/2011
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