Organization
ANIKA PHARMACY CORP
Active
Other names
lorven pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NARENDAR BOKKA (PRESIDENT)
(718) 649-9535
Entity
Organization
Contact information
Practice address
13929 BALTIMORE AVE STE 4, LAUREL, MD 20707-5045
(301) 490-8311
(301) 490-8244
Mailing address
13929 BALTIMORE AVE STE 4, LAUREL, MD 20707-5045
(301) 490-8311
(301) 490-8244
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P05590
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2136162
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/14/2011
Last updated
11/14/2011
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