355 Pharmacy & Medicals

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

355 PHARMACY & MEDICALS

Practice address

903 Russell Ave
Gaithersburg, MD 20879-3282

Phone

(240) 430-8940

Fax

(240) 430-8942

NPI assigned

Apr 9, 2021

Organization subpart

No

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

Authorized official

Name

Behrooz Goodarzi, PHARMACIST

Title

Pharmacist

Phone

(301) 254-4140

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617926400000",
    "number": "1104406529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 RUSSELL AVE",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793282",
            "telephone_number": "240-430-8940",
            "fax_number": "240-430-8942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 RUSSELL AVE",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793282",
            "telephone_number": "240-430-8940",
            "fax_number": "240-430-8942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "355 PHARMACY & MEDICALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-09",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A",
        "authorized_official_last_name": "GOODARZI",
        "authorized_official_first_name": "BEHROOZ",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "301-254-4140",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Gaithersburg",
            "affiliation": "N",
            "address_1": "903 Russell Ave",
            "city": "Gaithersburg",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208793282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Gaithersburg, MD
• Pharmacy in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.