MEDICARE: MED.ONE PHARMACY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	P05542	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194003087
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MED.ONE PHARMACY, INC.

Provider Business Mailing Address
First Line	:	10119 OLD OCEAN CITY BLVD
Second Line	:
City	:	BERLIN
State	:	MD
Zip	:	21811-1143
Country	:	US
Telephone Number	:	410-489-2708
Fax Number	:	410-489-2762

Provider Business Practice Location Address
First Line	:	10119 OLD OCEAN CITY BLVD
Second Line	:
City	:	BERLIN
State	:	MD
Zip	:	21811-1143
Country	:	US
Telephone Number	:	410-489-2708
Fax Number	:	410-489-2762

Authorized Official
Title or Position	:	PRESIDENT
Name	:	QAISAR FAROOQ
Credential	:
Telephone Number	:	773-983-4923

Provider Enumeration Date	:	07/27/2011
Last Update Date	:	10/09/2025

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