Healthcare Provider Details

I. General information

NPI: 1841559366
Provider Name (Legal Business Name): U S APOTHECARY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2012
Last Update Date: 05/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9106 PHILADELPHIA RD
ROSEDALE MD
21237-4329
US

IV. Provider business mailing address

9106 PHILADELPHIA RD
ROSEDALE MD
21237-4329
US

V. Phone/Fax

Practice location:
  • Phone: 410-294-3884
  • Fax:
Mailing address:
  • Phone: 410-294-3884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN F VANWIE
Title or Position: CFO
Credential: P.D.
Phone: 410-294-3884