Healthcare Provider Details

I. General information

NPI: 1104658699
Provider Name (Legal Business Name): LMCRX LTC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

7140 CONTEE RD # 1200B
LAUREL MD
20707-9527
US

IV. Provider business mailing address

7140 CONTEE RD # 1200B
LAUREL MD
20707-9527
US

V. Phone/Fax

Practice location:
  • Phone: 301-467-4140
  • Fax:
Mailing address:
  • Phone: 301-467-4140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. EJIKE I UNEGBU
Title or Position: PHARMACIST
Credential: PHARMD
Phone: 301-467-4140