John Wayne Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P04404 Issued in MD

Legal business name

JOHN WAYNE PHARMACY LLC

Doing business as

Professional Pharmacy

Practice address

9106 Philadelphia Rd
Ste 100
Baltimore, MD 21237-4329

Phone

(410) 687-8113

Fax

(410) 391-3922

NPI assigned

Jun 13, 2006

Last updated

Nov 16, 2016By 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

John Wayne, PD

Title

Pharmacist and Owner

Phone

(410) 687-8113

Specialties & licenses 6

Addresses

Other identifiers 2

Other names 1

• PROFESSIONAL PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479254400000",
    "number": "1457394108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 RITCHIE HWY STE 208",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211464137",
            "telephone_number": "410-294-3884",
            "fax_number": "410-544-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9106 PHILADELPHIA RD",
            "address_2": "STE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212374329",
            "telephone_number": "410-687-8113",
            "fax_number": "410-391-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN WAYNE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2016-11-16",
        "status": "A",
        "authorized_official_last_name": "WAYNE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PHARMACIST AND OWNER",
        "authorized_official_telephone_number": "410-687-8113",
        "authorized_official_credential": "PD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P04404",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011018300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2034379",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROFESSIONAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John P. Miller, M.D.
• John R Senatore DPM
• John W. Bowie, M.D.,P.a.
• John Wayne Pharmacy LLC (Professional Pharmacy)
• John Wayne Pharmacy LLC (Professional Pharmacy)
• Amballur John, M.D.
• Anett Maria John
• Asia John
• Daniel John, M.D.
• Jernelle Sharon John, MD

• 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 Nov 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.