NPIMap

Organization Active NPI

Three Lower Counties Community Services Inc

Doing business as Delmarva Pharmacy

  • Community/Retail Pharmacy
  • Salisbury, MD
National Provider Identifier
1194768473
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P07848 Issued in MD
Legal business name
THREE LOWER COUNTIES COMMUNITY SERVICES INC
Doing business as
Delmarva Pharmacy
Practice address
1615 Tree Sap CT
Salisbury, MD 21804
Phone
(410) 677-0561
Fax
(410) 677-0562
NPI assigned
Jun 14, 2006
Last updated
Oct 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Authorized official

Name
Mr. Brian E Holland
Title
President & Ceo
Phone
(410) 749-1015

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X P04378 MD
Community/Retail Pharmacy 3336C0003X P07848 MD Primary
Long Term Care Pharmacy 3336L0003X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

1615 Tree Sap CT
Salisbury, MD 21804

Mailing address

1615 Tree Sap CT
Salisbury, MD 21804-9403
Phone (410) 677-0561

Other identifiers 3

IdentifierTypeStateIssuer
2038111OtherPK
1194768473MedicaidDE
006044500MedicaidMD

Other names 1

  • Delmarva Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231201000102 MD Part B Supplier - Pharmacy 3678484300 Practice locations: Salisbury, MD

Other NPIs with the same Medicare PAC ID 23

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 23

National Provider Directory

National Provider Directory
Tax ID family
Abdul K Garuba37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Locations

1615 Tree Sap Ct
Salisbury, MD 21804
Phone (410) 677-0561

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Chesapeake Health CarePrincess Anne, MD, CCN 211935 Federally qualified health center Operational/Managerial Control Jun 1, 2018
Chesapeake Health CareBerlin, MD, CCN 211937 Federally qualified health center Operational/Managerial Control Feb 28, 1994
Chesapeake Health CareSalisbury, MD, CCN 211941 Federally qualified health center Operational/Managerial Control Feb 28, 1994
Chesapeake Health CarePocomoke City, MD, CCN 211943 Federally qualified health center Operational/Managerial Control Feb 28, 1994
Chesapeake Health CareSalisbury, MD, CCN 211010 Federally qualified health center Operational/Managerial Control Feb 28, 1994
Chesapeake Health CareBerlin, MD, CCN 211025 Federally qualified health center Operational/Managerial Control Feb 28, 1994

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 124

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.

View all 124

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1194768473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 TREE SAP CT",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218049403",
            "telephone_number": "410-677-0561",
            "fax_number": "410-677-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 TREE SAP CT",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "21804",
            "telephone_number": "410-677-0561",
            "fax_number": "410-677-0562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE LOWER COUNTIES COMMUNITY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "410-749-1015",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P04378",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P07848",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2038111",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194768473",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006044500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delmarva Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.