S & R Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P05823 Issued in MD

Legal business name

S & R PHARMACY LLC

Doing business as

Fuller Medical Center Pharmacy

Practice address

6918 Ridge Rd
Baltimore, MD 21237-3854

Phone

(410) 574-1440

Fax

(410) 574-1970

NPI assigned

Nov 28, 2006

Organization subpart

No

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

Authorized official

Name

Syam Potluri, B.PHARMNPI 1184931537

Title

Pharmacy Manager

Phone

(410) 574-1440

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• FULLER MEDICAL CENTER PHARMACY Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Syam Kumar Potluri, B.PHARM

  • Pharmacist
  • Baltimore, MD
  • NPI 1184931537
  NPD Authorized official

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655424000000",
    "number": "1134295207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6918 RIDGE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373854",
            "telephone_number": "410-574-1440",
            "fax_number": "410-574-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6918 RIDGE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373854",
            "telephone_number": "410-574-1440",
            "fax_number": "410-574-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S & R PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A",
        "authorized_official_last_name": "POTLURI",
        "authorized_official_first_name": "SYAM",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "410-574-1440",
        "authorized_official_credential": "B.PHARM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P05823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2138118",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FULLER MEDICAL CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FULLER MEDICAL CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Baltimore, MD
• Providers in Baltimore, 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 Jun 17, 2022; 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.