Healthcare Provider Details

I. General information

NPI: 1194003087
Provider Name (Legal Business Name): MED.ONE PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2011
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10119 OLD OCEAN CITY BLVD
BERLIN MD
21811-1143
US

IV. Provider business mailing address

10119 OLD OCEAN CITY BLVD
BERLIN MD
21811-1143
US

V. Phone/Fax

Practice location:
  • Phone: 410-489-2708
  • Fax: 410-489-2762
Mailing address:
  • Phone: 410-489-2708
  • Fax: 410-489-2762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP05542
License Number StateMD

VIII. Authorized Official

Name: QAISAR FAROOQ
Title or Position: PRESIDENT
Credential:
Phone: 773-983-4923