NPIMap

Organization Active NPI

Intrade Inc

Doing business as Crain Towers Pharmacy

  • Pharmacy
  • Glen Burnie, MD
National Provider Identifier
1255438180
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
P03144 Issued in MD
Legal business name
INTRADE INC
Doing business as
Crain Towers Pharmacy
Practice address
1600 Crain Hwy S
Ste 110
Glen Burnie, MD 21061-5577
Phone
(410) 760-4595
Fax
(410) 760-1575
NPI assigned
Sep 20, 2006
Last updated
Jun 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Authorized official

Name
Manish ShahNPI 1174910038
Title
Owner Pharmacist
Phone
(410) 760-4595

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X P03144 MD Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

1600 Crain Hwy S
Ste 110
Glen Burnie, MD 21061-5577

Mailing address

1600 Crain Hwy S
Ste 110
Glen Burnie, MD 21061-5577
Phone (410) 760-4595

Other identifiers 2

IdentifierTypeStateIssuer
000151100MedicaidMD
2037774OtherPK

Other names 1

  • CRAIN TOWERS PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

1600 Crain Hwy S
Ste 110
Glen Burnie, MD 21061
Phone (410) 760-1570

Practitioners & affiliated clinicians

Practitioners 2

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466035200000",
    "number": "1255438180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 CRAIN HWY S",
            "address_2": "STE 110",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615577",
            "telephone_number": "410-760-4595",
            "fax_number": "410-760-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CRAIN HWY S",
            "address_2": "STE 110",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615577",
            "telephone_number": "410-760-4595",
            "fax_number": "410-760-1575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTRADE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-06-16",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "MANISH",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "410-760-4595"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MD",
            "license": "P03144",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000151100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2037774",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRAIN TOWERS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 16, 2016; 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.