Eastern Avenue Pharmacy and Medical Equipment, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P06257 Issued in MD

Legal business name

EASTERN AVENUE PHARMACY AND MEDICAL EQUIPMENT, LLC

Practice address

5901 Eastern Ave
D
Baltimore, MD 21224

Phone

(410) 929-8455

Fax

(410) 929-8368

NPI assigned

Sep 27, 2013

Organization subpart

No

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

Authorized official

Name

Adjarho EgbegbadiaNPI 1780088427

Title

Manager

Phone

(410) 929-8455

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adjarho Egbegbadia

  • Pharmacist
  • Baltimore, MD
  • NPI 1780088427
  NPD (past) Authorized official

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398211200000",
    "number": "1356778971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 EASTERN AVE.",
            "address_2": "SUITE D",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242731",
            "telephone_number": "410-929-8455",
            "fax_number": "410-929-8368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 EASTERN AVE",
            "address_2": "D",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21224",
            "telephone_number": "410-929-8455",
            "fax_number": "410-929-8368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN AVENUE PHARMACY AND MEDICAL EQUIPMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-27",
        "last_updated": "2014-04-23",
        "status": "A",
        "authorized_official_last_name": "EGBEGBADIA",
        "authorized_official_first_name": "ADJARHO",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "410-929-8455"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P06257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDBOP",
            "identifier": "P06257",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eastern Avenue Dental, LLC
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• Eastern Avenue Health Solutions Inc.
• Eastern Avenue Health Solutions, Inc
• Eastern Avenue Injury Center, LLC
• Katherine Easthope
• Julie A Eastin, PH.D
• Karla Easton, PHARMD
• Gabriel Eastwood
• Easy Choice Wellness Center LLC

• Community/Retail Pharmacy in Baltimore, MD
• Providers in Baltimore, 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 Apr 23, 2014; 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.