=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366488165
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NETCARE RX FREDERICK LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/21/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 110 BAUGHMANS LN
-----------------------------------------------------
City | FREDERICK
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21702-4011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-698-1411
-----------------------------------------------------
Fax | 301-631-8275
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 110 BAUGHMANS LN
-----------------------------------------------------
City | FREDERICK
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21702-4011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | AREA MGR
-----------------------------------------------------
Name | JAMES DIPAULA
-----------------------------------------------------
Credential | RPH BS MBA
-----------------------------------------------------
Telephone | 443-276-1020
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | P01898
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0002X
-----------------------------------------------------
Taxonomy Name | Clinic Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------