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General NPI Number Information
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NPI Number | 1669462156
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Entity Type | Organization
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Legal Business Name | S & R CATONSVILLE LLC
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 06/17/2022
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Provider Practice Location Address
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Address Line | 6483 BALTIMORE NATIONAL PIKE
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City | CATONSVILLE
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State | MD
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Zip | 21228-3904
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Country | US
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Telephone | 410-869-9833
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Fax | 410-869-9834
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Provider Business Mailing Address
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Address Line | 6483 BALTIMORE NATIONAL PIKE
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City | CATONSVILLE
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State | MD
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Zip | 21228-3904
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Country | US
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Telephone | 410-869-9833
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Fax | 410-869-9834
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. SYAM K POTLURI
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Credential | R. PH
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Telephone | 443-823-3350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P02474
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License Number State | MD
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