NPIMap

Organization Active NPI

Laurel Main Street Pharmacy

  • Long Term Care Pharmacy
  • Laurel, MD
National Provider Identifier
1043968530
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
LAUREL MAIN STREET PHARMACY
Practice address
667 Main St
Laurel, MD 20707-4067
Phone
(301) 317-3838
Fax
(301) 317-3637
NPI assigned
Mar 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ali H Thakkar, PHARMD
Title
Owner
Phone
(301) 317-3838

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X
Compounding Pharmacy 3336C0004X
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

667 Main St
Laurel, MD 20707-4067

Mailing address

667 Main St
Laurel, MD 20707-4067
Phone (301) 317-3838

Other identifiers 3

IdentifierTypeStateIssuer
443806000MedicaidMD
037359100MedicaidDC
336716900MedicaidMD

Other names 1

  • Main Street Pharmacy Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@msrxlaurel.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Laurel Main Street Pharmacy Incorporated3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1043968530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 MAIN ST",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074067",
            "telephone_number": "301-317-3838",
            "fax_number": "301-317-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 MAIN ST",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074067",
            "telephone_number": "301-317-3838",
            "fax_number": "301-317-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL MAIN STREET PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-14",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "THAKKAR",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-317-3838",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "443806000",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037359100",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336716900",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@msrxlaurel.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "667 Main St",
            "city": "Laurel",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207074067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Main Street Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Main Street Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.