Organization Active NPI

Empire Professional Pharmacy Inc

  • Community/Retail Pharmacy
  • Glen Burnie, MD
National Provider Identifier
1194752667
Registry record updated Oct 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
EMPIRE PROFESSIONAL PHARMACY INC
Practice address
200 Hospital Dr
Ste 107
Glen Burnie, MD 21061-5884
Phone
(410) 787-0030
Fax
(410) 787-0030
NPI assigned
Jun 28, 2006
Last updated
Oct 24, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2017

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

Authorized official

Name
Mr. Jeremy Cundiff
Title
President
Phone
(410) 787-0030

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X P00948 MD
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

200 Hospital Dr
Ste 107
Glen Burnie, MD 21061-5884

Mailing address

200 Hospital Dr
Ste 107
Glen Burnie, MD 21061-5884
Phone (410) 787-0030

Other identifiers 3

IdentifierTypeStateIssuer
2112009OtherOTHER ID NUMBER-COMMERCIAL NUMBER
256723000MedicaidMD
419578700MedicaidMD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508803200000",
    "number": "1194752667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL DR",
            "address_2": "STE 107",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615884",
            "telephone_number": "410-787-0030",
            "fax_number": "410-787-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL DR",
            "address_2": "STE 107",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615884",
            "telephone_number": "410-787-0030",
            "fax_number": "410-787-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPIRE PROFESSIONAL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2017-10-24",
        "status": "A",
        "authorized_official_last_name": "CUNDIFF",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-787-0030",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MD",
            "license": "P00948",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2112009",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256723000",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "419578700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.