Blue Door Pharmacies

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P05361 Issued in MD

Legal business name

BLUE DOOR PHARMACIES

Doing business as

Shady Grove Pharmacy

Practice address

15225 Shady Grove Rd
Suite 101
Rockville, MD 20850-3254

Phone

(301) 948-4222

Fax

(301) 948-0018

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Sheila Alizadeh

Title

Owner

Phone

(240) 731-2813

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shady Grove Pharmacy Doing business as

Tax ID family

Blue Door Pharmacies2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Blue Door Pharmacies

  • Community/Retail Pharmacy
  • Rockville, MD
  • NPI 1902127087
  NPD tax ID

Locations

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427760000000",
    "number": "1245245851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15225 SHADY GROVE RD",
            "address_2": "SUITE 101",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503254",
            "telephone_number": "301-948-4222",
            "fax_number": "301-948-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15225 SHADY GROVE RD",
            "address_2": "SUITE 101",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503254",
            "telephone_number": "301-948-4222",
            "fax_number": "301-948-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE DOOR PHARMACIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2015-03-31",
        "status": "A",
        "authorized_official_last_name": "ALIZADEH",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-731-2813"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P05361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2126425",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shady Grove Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicholas Bloomer
• Marnee Bloomfield, STUDENT
• Leah Taiba Bloshteyn
• Mary Ann Blotzer, LCSW C
• Anthony Blount
• Blue Door Pharmacies
• Blue Moon Behavioral Health, PLLC
• Keira Blue
• Shaniya Blue
• Bluefish Therapy and Consulting, LLC

• Community/Retail Pharmacy in Rockville, MD
• Providers in Rockville, 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 Mar 31, 2015; 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.