Main Street Pharmacy, LLC

NPI #1821198110 in Parkville, Maryland

Provider Information

NPI Number: 1821198110
Entity Type: Organization
Organization Name: Main Street Pharmacy, LLC
Primary Specialty: Pharmacy
Enumeration Date: Sep 25, 2006
Last Updated: Aug 1, 2016

Practice Location

Address: 8800 WALTHER BLVD
City: Parkville
State: Maryland
ZIP Code: 21234-9001
Phone: (410) 882-3238

Authorized Official

Name: SUSAN COLBERT
Title: SR. DIRECTOR, PAYER RELATIONS
Phone: (401) 770-2751

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy	3336C0003X
Durable Medical Equipment & Medical Supplies	332B00000X
Pharmacy	333600000X	Primary

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