Mt Vernon Pharmacy At Fallsway Inc

LBN: Mt Vernon Pharmacy At Fallsway Inc
Mt Vernon Pharmacy At Fallsway Inc is an health care organization with primary practice located at 421 Fallsway , Baltimore MD 21202-4800. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Mt Vernon Pharmacy At Fallsway Inc can be contacted via phone (410) 962-1100, or through Wienner, Stephen via phone (410) 962-1100.

Contact Information

Primary practice address
421 Fallsway Baltimore MD 21202-4800
Phone: (410) 962-1100
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wienner, Stephen
Phone: (410) 962-1100

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X P05345 Maryland
Suppliers / Specialty Pharmacy 3336S0011X P05345 Maryland

Profile Details

NPI number 1770985061
LBN Legal business name Mt Vernon Pharmacy At Fallsway Inc
DBA Doing business as
Authorized official Wienner, Stephen
Entity Organization
Organization subpart 1 No
Enumeration date Sep 18th, 2014
Last updated Sep 18th, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770985061 NPPES
Maryland Other 208979 MEDICARE MASS IMMUNIZER PTAN
Maryland MEDICAID 036258100 MEDICARE MASS IMMUNIZER PTAN
Maryland MEDICAID 036800800 MEDICARE MASS IMMUNIZER PTAN

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