Healthcare Provider Details

I. General information

NPI: 1386016319
Provider Name (Legal Business Name): UNIVERSITY OF MARYLAND MEDICAL REGIONAL SUPPLIER SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2015
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 SPARROWS POINT BLVD STE 513
EDGEMERE MD
21219-1462
US

IV. Provider business mailing address

1390 SPARROWS POINT BLVD
EDGEMERE MD
21219-1462
US

V. Phone/Fax

Practice location:
  • Phone: 410-462-5850
  • Fax: 410-636-0309
Mailing address:
  • Phone: 443-462-5850
  • Fax: 410-636-0309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPW0484
License Number StateMD

VIII. Authorized Official

Name: DOUGLAS LASCH
Title or Position: PHARMACY DIRECTOR
Credential:
Phone: 443-462-5850