Organization Active NPI

St Johns Pharmacy Inc

Doing business as St Johns Progressive Pharmacy

  • Community/Retail Pharmacy
  • Hollywood, MD
National Provider Identifier
1245397678
Registry record updated Dec 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P01320 Issued in MD
Legal business name
ST JOHNS PHARMACY INC
Doing business as
St Johns Progressive Pharmacy
Practice address
24288 Three Notch Rd
Hollywood, MD 20636
Phone
(301) 373-3340
Fax
(301) 373-3691
NPI assigned
Jan 3, 2007
Last updated
Dec 26, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2012

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

Authorized official

Name
Leo Mallard, RPH
Title
Owner
Phone
(410) 741-5150

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X P01320 MD Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

24288 Three Notch Rd
Hollywood, MD 20636

Mailing address

PO Box 790
Hollywood, MD 20636-0790
Phone (301) 373-3340

Other names 1

  • ST JOHNS PROGRESSIVE PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

24288 Three Notch Rd
Hollywood, MD 20636
Phone (301) 373-3113

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356480000000",
    "number": "1245397678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206360790",
            "telephone_number": "301-373-3340",
            "fax_number": "301-373-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24288 THREE NOTCH RD",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "20636",
            "telephone_number": "301-373-3340",
            "fax_number": "301-373-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHNS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2012-12-26",
        "status": "A",
        "authorized_official_last_name": "MALLARD",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-741-5150",
        "authorized_official_credential": "RPH"
    },
    "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": "P01320",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST JOHNS PROGRESSIVE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hollywood, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; 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.