Mercantile Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MERCANTILE PHARMACY

Practice address

1400 Mercantile LN Ste 252
Largo, MD 20774-5333

Phone

(301) 404-6067

NPI assigned

Aug 22, 2022

Last updated

Aug 22, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kapiamba MutebaNPI 1841527447

Title

Ceo

Phone

(301) 404-6067

Specialties & licenses 1

Addresses

Locations

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.

• Kapiamba Muteba

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Washington, DC
  • NPI 1841527447
  Authorized official Same address or phone

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1386363679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 S CAPITOL ST SW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200322308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MERCANTILE LN STE 252",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745333",
            "telephone_number": "301-404-6067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCANTILE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "MUTEBA",
        "authorized_official_first_name": "KAPIAMBA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-404-6067"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Largo, MD
• Providers in Largo, 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 Aug 22, 2022; 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.