NPIMap

Organization Active NPI

Baltimore Medical System Inc

Doing business as Baltimore Medical System Inc Pharmacy

  • Community/Retail Pharmacy
  • Baltimore, MD
National Provider Identifier
1073754461
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P04992 Issued in MD
Legal business name
BALTIMORE MEDICAL SYSTEM INC
Doing business as
Baltimore Medical System Inc Pharmacy
Practice address
3120 Erdman Ave
Baltimore, MD 21213-1720
Phone
(443) 703-3683
Fax
(410) 534-0143
NPI assigned
Mar 13, 2009
Reactivated
Jun 1, 2023
Last updated
Dec 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Authorized official

Name
Dawn JacobsNPI 1952810947
Title
Director of Pharmacy Services
Phone
(443) 703-3654

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X P04992 MD Primary

Addresses

Primary practice location

3120 Erdman Ave
Baltimore, MD 21213-1720

Mailing address

5525 Eastern Ave Ste 301
Baltimore, MD 21224-2796
Phone (443) 703-3654

Other identifiers 2

IdentifierTypeStateIssuer
416605100MedicaidMD
2119406OtherPK

Other names 1

  • Baltimore Medical System Inc Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Baltimore Medical System Inc23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Practitioners & affiliated clinicians

Practitioners 1

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": "1236902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701993600000",
    "number": "1073754461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 EASTERN AVE STE 301",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242796",
            "telephone_number": "443-703-3654",
            "fax_number": "443-703-3639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 ERDMAN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212131720",
            "telephone_number": "443-703-3683",
            "fax_number": "410-534-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALTIMORE MEDICAL SYSTEM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-13",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "deactivation_date": "2023-05-13",
        "reactivation_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY SERVICES",
        "authorized_official_telephone_number": "443-703-3654"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "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": "MD",
            "license": "P04992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "416605100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2119406",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baltimore Medical System Inc Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baltimore Medical System Inc Pharmacy",
            "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 Dec 8, 2023; 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.