Organization
LOCH RAVEN PHARMACY INC
Active
Other names
Campus Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANWAR YOUSUF PHARMD (PRESIDENT)
(410) 323-1515
Entity
Organization
Contact information
Practice address
1101 N CALVERT ST UNIT 3, BALTIMORE, MD 21202-3840
(410) 433-9434
(410) 433-9436
Mailing address
1101 N CALVERT ST UNIT 3, BALTIMORE, MD 21202-3840
(410) 433-9434
(410) 433-9436
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
P05311
MD
3336C0003X
Community/Retail Pharmacy
Primary
P05311
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
419724100
—
MD
01
—
D13440565
STAE TAX ID #
MD
01
—
P05311
PHARMACY PERMIT #
MD
Enumeration date
04/09/2010
Last updated
10/31/2023
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