Watermont Pharmacy

LBN: Watermont Pharmacy
Watermont Pharmacy is an health care organization with primary practice located at 4900 Waterloo Rd # A , Ellicott City MD 21043-6664. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Watermont Pharmacy can be contacted via phone (410) 465-0552, or through Lare, Jodi via phone (410) 465-0552.

Contact Information

Primary practice address
4900 Waterloo Rd # A Ellicott City MD 21043-6664
Phone: (410) 465-0552
Fax: (410) 465-0553
Website:
Map and Directions
Authorized official contact:
Name: Lare, Jodi RPH
Phone: (410) 465-0552

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X P00820 Maryland

Profile Details

NPI number 1114969730
LBN Legal business name Watermont Pharmacy
DBA Doing business as Watermont Pharmacy
Authorized official Lare, Jodi RPH
Entity Organization
Organization subpart 1 No
Enumeration date Jun 11th, 2006
Last updated Apr 22nd, 2011 - about 15 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 1114969730 NPPES
Other 2103896 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID 011682300 NCPDP PROVIDER IDENTIFICATION NUMBER

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