Laurel Main Street Pharmacy Incorporated | |
667 Main St Laurel MD 20707-4067 | |
(301) 317-3838 | |
(301) 317-3637 |
Full Name | Laurel Main Street Pharmacy Incorporated |
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Speciality | Pharmacy |
Location | 667 Main St, Laurel, Maryland |
Authorized Official Name and Position | Ali H Thakkar (PRESIDENT) |
Authorized Official Contact | 3013173838 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Laurel Main Street Pharmacy Incorporated 667 Main St Laurel MD 20707-4067 Ph: (301) 317-3838 | Laurel Main Street Pharmacy Incorporated 667 Main St Laurel MD 20707-4067 Ph: (301) 317-3838 |
NPI Number | 1023058690 |
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Provider Enumeration Date | 06/08/2006 |
Last Update Date | 09/14/2023 |
Medicare PECOS PAC ID | 0840368916 |
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Medicare Enrollment ID | O20081003000141 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023058690 | NPI | - | NPPES |
0029793 | Medicaid | MD | |
4097696 | Medicaid | MD |
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