NPIMap

Organization Active NPI

Old Line Healthcare Inc

Doing business as Potomac Pharmatech

  • Long Term Care Pharmacy
  • Williamsport, MD
National Provider Identifier
1356489348
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PW0296 Issued in MD
Legal business name
OLD LINE HEALTHCARE INC
Doing business as
Potomac Pharmatech
Practice address
16107A Elliott Pkwy
Williamsport, MD 21795-4084
Phone
(301) 223-6616
Fax
(301) 223-6679
NPI assigned
Feb 2, 2007
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
Eric Shelley, R PHNPI 1164580056
Title
VP of Operations
Phone
(717) 848-3445

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X MO0560293 WV
Long Term Care Pharmacy 3336L0003X PW0296 MD Primary
Mail Order Pharmacy 3336M0002X

Addresses

Primary practice location

16107A Elliott Pkwy
Williamsport, MD 21795-4084

Mailing address

16107A Elliott Pkwy
Williamsport, MD 21795-4084
Phone (301) 223-6616

Other names 1

  • POTOMAC PHARMATECH Doing business as

National Provider Directory

National Provider Directory

Locations

16107A Elliott Pkwy
Williamsport, MD 21795
Phone (301) 223-6616

Practitioners & affiliated clinicians

Practitioners 1

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": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466035200000",
    "number": "1356489348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16107A ELLIOTT PKWY",
            "city": "WILLIAMSPORT",
            "state": "MD",
            "postal_code": "217954084",
            "telephone_number": "301-223-6616",
            "fax_number": "301-223-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16107A ELLIOTT PKWY",
            "city": "WILLIAMSPORT",
            "state": "MD",
            "postal_code": "217954084",
            "telephone_number": "301-223-6616",
            "fax_number": "301-223-6679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD LINE HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2016-06-16",
        "status": "A",
        "authorized_official_last_name": "SHELLEY",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "717-848-3445",
        "authorized_official_credential": "R PH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WV",
            "license": "MO0560293",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MD",
            "license": "PW0296",
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "POTOMAC PHARMATECH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsport, 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.