Active NPI
Jerry Van, PHARMD
- Pharmacist
- Hagerstown, MD
National Provider Identifier
1427979301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 24364
- Practice address
- 11116 Medical Campus Rd
Hagerstown, MD 21742-6710 - Phone
- (301) 790-8925
- NPI assigned
- Jul 24, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 24364 | MD | Primary |
Addresses
Primary practice location
11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Mailing address
7152 Proclamation PL
Frederick, MD 21703-2980
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1784851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784851200000",
"number": "1427979301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7152 PROCLAMATION PL",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217032980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11116 MEDICAL CAMPUS RD",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217426710",
"telephone_number": "301-790-8925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN",
"first_name": "JERRY",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-07-24",
"last_updated": "2026-07-24",
"certification_date": "2026-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "24364",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hagerstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.