Healthcare Provider Details

I. General information

NPI: 1699708263
Provider Name (Legal Business Name): METCARE RX LAUREL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7419 VAN DUSEN RD
LAUREL MD
20707-6400
US

IV. Provider business mailing address

7419 VAN DUSEN RD
LAUREL MD
20707-6400
US

V. Phone/Fax

Practice location:
  • Phone: 301-498-3972
  • Fax: 301-604-6082
Mailing address:
  • Phone: 301-498-3972
  • Fax: 301-604-6082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPO1070
License Number StateMD

VIII. Authorized Official

Name: GINA HUNT
Title or Position: SENIOR VP CORPORATE REVENUE
Credential:
Phone: 954-653-1040