Cleveland Enterprise II LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P07442 Issued in MD

Legal business name

CLEVELAND ENTERPRISE II LLC

Doing business as

MECMO Pharmacy

Practice address

5831 Allentown Rd
Camp Springs, MD 20746-4570

Phone

(786) 385-0917

Fax

(301) 909-0697

NPI assigned

Jan 24, 2017

Last updated

Apr 19, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Otis Cleveland

Title

Ceo

Phone

(786) 385-0917

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MECMO Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1144767575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5831 ALLENTOWN RD",
            "city": "CAMP SPRINGS",
            "state": "MD",
            "postal_code": "207464570",
            "telephone_number": "786-385-0917",
            "fax_number": "301-909-0697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5831 ALLENTOWN RD",
            "city": "CAMP SPRINGS",
            "state": "MD",
            "postal_code": "207464570",
            "telephone_number": "786-385-0917",
            "fax_number": "301-909-0697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND ENTERPRISE II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-24",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "CLEVELAND",
        "authorized_official_first_name": "OTIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-385-0917"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P07442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2165891",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MECMO Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Camp Springs, MD
• Providers in Camp Springs, 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 19, 2017; 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.