Provider Demographics
NPI:1396133625
Name:SLPHARMACY INC.
Entity type:Organization
Organization Name:SLPHARMACY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:NARASIMHA
Authorized Official - Middle Name:RAO
Authorized Official - Last Name:YANAMADDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-666-7636
Mailing Address - Street 1:2014 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-5902
Mailing Address - Country:US
Mailing Address - Phone:410-528-6010
Mailing Address - Fax:410-244-1519
Practice Address - Street 1:2014 MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-5902
Practice Address - Country:US
Practice Address - Phone:410-528-6010
Practice Address - Fax:410-244-1519
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SLPHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-01-09
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP066683336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy