Organization
ST MARYS PHARMACY LLC
Active
Other names
St Marys Pharmacy llc
Organization subpart
No
Provider details
NPI number
Authorized official
TANUJA KATTA (PHARMACIST INCHARGE)
(301) 768-9117
Entity
Organization
Contact information
Practice address
25482 POINT LOOKOUT RD BLDG 2, LEONARDTOWN, MD 20650-3895
(301) 475-2025
(301) 475-2026
Mailing address
25482 POINT LOOKOUT RD, BUILDING 2 UNIT 203C, LEONARDTOWN, MD 20650-3895
(301) 475-2025
(301) 475-2026
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
05680
MD
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2134609
PK
—
Enumeration date
03/10/2012
Last updated
03/15/2017
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