Healthcare Provider Details

I. General information

NPI: 1588496079
Provider Name (Legal Business Name): LAUREL MEDICAL CENTER PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 10/12/2024
Certification Date: 10/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7140 CONTEE RD # 1200
LAUREL MD
20707-9527
US

IV. Provider business mailing address

7140 CONTEE RD # 1200
LAUREL MD
20707-9527
US

V. Phone/Fax

Practice location:
  • Phone: 301-849-1202
  • Fax: 301-849-1201
Mailing address:
  • Phone: 301-849-1201
  • Fax: 301-849-1202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code331L00000X
TaxonomyBlood Bank
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. OBIANUJU NWADINIGWE
Title or Position: MANAGER
Credential:
Phone: 301-467-4140