Organization Active NPI

Denton Pharmacy LLC

  • Community/Retail Pharmacy
  • Denton, MD
National Provider Identifier
1417040858
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P01605 Issued in MD
Legal business name
DENTON PHARMACY LLC
Practice address
508 S 5TH Ave
Denton, MD 21629-1368
Phone
(410) 479-1100
Fax
(410) 479-1240
NPI assigned
Sep 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Authorized official

Name
Brenda Walls
Title
Owner
Phone
(410) 479-1100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X P01605 MD Primary

Addresses

Primary practice location

508 S 5TH Ave
Denton, MD 21629-1368

Mailing address

508 S 5TH Ave
Denton, MD 21629-1368
Phone (410) 479-1100

Other identifiers 2

IdentifierTypeStateIssuer
401154600MedicaidMD
2034451OtherPK

Other names 1

  • DENTON PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Denton Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

508 S 5th Ave
Denton, MD 21629
Phone (410) 479-1100

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1417040858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 S 5TH AVE",
            "city": "DENTON",
            "state": "MD",
            "postal_code": "216291368",
            "telephone_number": "410-479-1100",
            "fax_number": "410-479-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 S 5TH AVE",
            "city": "DENTON",
            "state": "MD",
            "postal_code": "216291368",
            "telephone_number": "410-479-1100",
            "fax_number": "410-479-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTON PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-30",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-479-1100"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P01605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401154600",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2034451",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DENTON PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.