Watermont Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P00820 Issued in MD

Legal business name

WATERMONT PHARMACY

Practice address

4900 Waterloo Rd # a
Ellicott City, MD 21043-6664

Phone

(410) 465-0552

Fax

(410) 465-0553

NPI assigned

Jun 11, 2006

Organization subpart

No

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

Authorized official

Name

Jodi Lare, RPH

Title

Owner Pharmacist

Phone

(410) 465-0552

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• WATERMONT PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303430400000",
    "number": "1114969730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 WATERLOO RD # A",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436664",
            "telephone_number": "410-465-0552",
            "fax_number": "410-465-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 WATERLOO RD # A",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436664",
            "telephone_number": "410-465-0552",
            "fax_number": "410-465-0553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERMONT PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2011-04-22",
        "status": "A",
        "authorized_official_last_name": "LARE",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "410-465-0552",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P00820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2103896",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011682300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WATERMONT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Linda Warminski-Walls, OTR
• Hannah Grace Wascavage
• Sharon Washington
• Barbara Pearson Wasserman, M.D.
• Martin Paul Wasserman, M.D.
• Brian Avery Watson, PT
• Elizabeth Watson
• Pei-Yu Katherine Watts, CRNA
• Burton Mark Waxman, D.D.S.
• Way Station, Inc.

• Community/Retail Pharmacy in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Community/Retail Pharmacy in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2011; 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.