Active NPI
Independent Drug Immunization LLC
- Community/Retail Pharmacy
- Baltimore, MD
National Provider Identifier
1104238427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- P04009
- Legal business name
- INDEPENDENT DRUG IMMUNIZATION LLC
- Practice address
- 28 Kingston Rd
Baltimore, MD 21220-4814 - Phone
- (410) 687-1115
- Fax
- (410) 687-0032
- NPI assigned
- May 21, 2014
- Organization subpart
- Yes
- Parent organization
- INDEPENDENT DRUG
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- George Garmer
- Title
- President
- Phone
- (410) 207-5751
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | P04009 | MD | Primary |
Addresses
Primary practice location
28 Kingston Rd
Baltimore, MD 21220-4814
Mailing address
28 Kingston Rd
Baltimore, MD 21220-4814
Phone (410) 687-1115
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 404088100 | Medicaid | MD |
Other names 1
- Marelaine Inc
National Provider Directory
National Provider Directory- Part of
- Marelaine Inc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400630400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1400630400000",
"number": "1104238427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 KINGSTON RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212204814",
"telephone_number": "410-687-1115",
"fax_number": "410-687-0032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 KINGSTON RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212204814",
"telephone_number": "410-687-1115",
"fax_number": "410-687-0032"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INDEPENDENT DRUG IMMUNIZATION LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "INDEPENDENT DRUG",
"enumeration_date": "2014-05-21",
"last_updated": "2014-05-21",
"status": "A",
"authorized_official_last_name": "GARMER",
"authorized_official_first_name": "GEORGE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "410-207-5751"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MD",
"license": "P04009",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "404088100",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Marelaine Inc",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Baltimore, MD
- Independence Foundation, Inc.
- Independent Dialysis Foundation
- Independent Dialysis Foundation, Inc
- Independent Dialysis Foundation, Inc
- Independent Dialysis Foundation, Inc
- Indigo Physiotherapy, LLC
- Indigo Roland Park LLC
- Joan Lynn Indilisano, OTR/L
- Individual Home Care LLC
- Individualized Psychological Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.