Organization
KPM SPECIALTY HOLDINGS INC
Active
Other names
KPM Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONIO TOMLINSON (PHARMACY MANAGER)
(240) 619-3407
Entity
Organization
Contact information
Practice address
8700 CENTRAL AVE STE 301, OMNI MEDICAL BLDG, LANDOVER, MD 20785-4853
(240) 619-3407
(202) 318-0440
Mailing address
8700 CENTRAL AVE STE 301, OMNI MEDICAL BLDG, LANDOVER, MD 20785-4853
(240) 619-3407
(202) 318-0440
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336M0003X
Managed Care Organization Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
PW0376
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2137203
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/21/2013
Last updated
03/21/2013
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