Provider Demographics
NPI:1962595306
Name:YOUR COMM PHCY INC
Entity type:Organization
Organization Name:YOUR COMM PHCY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RPH
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEIKACH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:410-744-5959
Mailing Address - Street 1:400 S HAMMONDS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2411
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 S HAMMONDS FERRY RD
Practice Address - Street 2:
Practice Address - City:LINTHICUM
Practice Address - State:MD
Practice Address - Zip Code:21090-2411
Practice Address - Country:US
Practice Address - Phone:410-859-0555
Practice Address - Fax:410-859-5653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP044743336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2133053OtherOTHER ID NUMBER-COMMERCIAL NUMBER