Organization Active NPI

Mid-Atlantic Ventures, Inc

Doing business as Westside Pharmacy & Wellness Ctr

  • Long Term Care Pharmacy
  • Baltimore, MD
National Provider Identifier
1073117750
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
MID-ATLANTIC VENTURES, INC
Doing business as
Westside Pharmacy & Wellness Ctr
Practice address
2021 W Pratt St
Baltimore, MD 21223-2242
Phone
(410) 566-1360
Fax
(410) 566-5088
NPI assigned
Nov 24, 2020
Last updated
Nov 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Authorized official

Name
Isaac Isaac Olajide
Title
Pharmacist Manager & Owner
Phone
(410) 566-1360

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X NU Primary

Addresses

Primary practice location

2021 W Pratt St
Baltimore, MD 21223-2242

Mailing address

2021 W Pratt St
Baltimore, MD 21223-2242
Phone (410) 566-1360

Other names 1

  • WESTSIDE PHARMACY & WELLNESS CTR Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1606176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606176000000",
    "number": "1073117750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 W PRATT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212232242",
            "telephone_number": "410-566-1360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 W PRATT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212232242",
            "telephone_number": "410-566-1360",
            "fax_number": "410-566-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-ATLANTIC VENTURES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-24",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "OLAJIDE",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_middle_name": "ISAAC",
        "authorized_official_title_or_position": "PHARMACIST MANAGER & OWNER",
        "authorized_official_telephone_number": "410-566-1360"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WESTSIDE PHARMACY & WELLNESS CTR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.