NPIMap

Organization Active NPI

Western Maryland Health Care Corporation

Doing business as Mountain Laurel Community Pharmacy at Grantsville

  • Community/Retail Pharmacy
  • Grantsville, MD
National Provider Identifier
1083415947
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
WESTERN MARYLAND HEALTH CARE CORPORATION
Doing business as
Mountain Laurel Community Pharmacy at Grantsville
Practice address
28 Hershberger LN
Grantsville, MD 21536-1172
Phone
(301) 895-5107
Fax
(833) 448-0359
NPI assigned
Mar 24, 2025
Last updated
Jan 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Authorized official

Name
James Mou
Title
Cfo
Phone
(301) 533-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

28 Hershberger LN
Grantsville, MD 21536-1172

Mailing address

28 Hershberger LN
Grantsville, MD 21536-1172
Phone (301) 901-3749

Other names 1

  • Mountain Laurel Community Pharmacy at Grantsville Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251113003603 MD DME Supplier - Pharmacy 9436152493 Practice locations: Grantsville, MD

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Western Maryland Health Care Corpor28 Hershberger LN, Grantsville, MD 21536-1172(301) 901-3749 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Nov 2, 2006

National Provider Directory

National Provider Directory
Tax ID family
Mountain Laurel Medical Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

888 Memorial Dr
Oakland, MD 21550
Phone (301) 334-1016

198 Morgantown St
Ste 2
Bruceton Mls, WV 26525
Phone (304) 379-7600

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768953600000",
    "number": "1083415947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 HERSHBERGER LN",
            "city": "GRANTSVILLE",
            "state": "MD",
            "postal_code": "215361172",
            "telephone_number": "301-901-3749",
            "fax_number": "301-786-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 HERSHBERGER LN",
            "city": "GRANTSVILLE",
            "state": "MD",
            "postal_code": "215361172",
            "telephone_number": "301-895-5107",
            "fax_number": "833-448-0359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN MARYLAND HEALTH CARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-24",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A",
        "authorized_official_last_name": "MOU",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-533-3300"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Laurel Community Pharmacy at Grantsville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mountain Laurel Community Pharmacy at Grantsville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grantsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.