NPIMap

Organization Active NPI

Antietam Health Services

Doing business as Home Care Pharmacy-Williamsport

  • Community/Retail Pharmacy
  • Williamsport, MD
National Provider Identifier
1104915321
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P02295 Issued in MD
Legal business name
ANTIETAM HEALTH SERVICES
Doing business as
Home Care Pharmacy-Williamsport
Practice address
307 E Potomac Street
Williamsport, MD 21795-1203
Phone
(301) 223-4100
Fax
(301) 223-6133
NPI assigned
Oct 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Laurence Allen Hickman Jr., RPHNPI 1417042011
Title
Pharmacist Manager
Phone
(301) 223-4100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X P02295 MD Primary

Addresses

Primary practice location

307 E Potomac Street
Williamsport, MD 21795-1203

Mailing address

307 E Potomac St
Williamsport, MD 21795-1203
Phone (301) 223-4100

Other names 1

  • Home Care Pharmacy-Williamsport Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Antietam Health10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the 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": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104915321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 E POTOMAC ST",
            "city": "WILLIAMSPORT",
            "state": "MD",
            "postal_code": "217951203",
            "telephone_number": "301-223-4100",
            "fax_number": "301-223-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 E POTOMAC STREET",
            "city": "WILLIAMSPORT",
            "state": "MD",
            "postal_code": "217951203",
            "telephone_number": "301-223-4100",
            "fax_number": "301-223-6133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTIETAM HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "LAURENCE",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PHARMACIST MANAGER",
        "authorized_official_telephone_number": "301-223-4100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P02295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Care Pharmacy-Williamsport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsport, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.