Healthcare Provider Details

I. General information

NPI: 1326021122
Provider Name (Legal Business Name): MED.ONE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2005
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7628 OLD NATIONAL PIKE
BOONSBORO MD
21713-2002
US

IV. Provider business mailing address

7628 OLD NATIONAL PIKE
BOONSBORO MD
21713-2002
US

V. Phone/Fax

Practice location:
  • Phone: 301-432-5488
  • Fax: 301-432-2466
Mailing address:
  • Phone: 301-432-5488
  • Fax: 301-432-2466

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 NumberP05879
License Number StateMD

VIII. Authorized Official

Name: QAISAR FAROOQ
Title or Position: PRESIDENT
Credential:
Phone: 301-432-5488