NPIMap

Organization Active NPI

Belvedere Pharmacy LLC

  • Community/Retail Pharmacy
  • Baltimore, MD
National Provider Identifier
1457475030
Registry record updated Feb 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P04553 Issued in MD
Legal business name
BELVEDERE PHARMACY LLC
Doing business as
BELVEDERE PHARMACY LLC
Practice address
3716 And One Half W Belverede Ave
Unit C
Baltimore, MD 21215
Phone
(410) 367-5628
Fax
(410) 367-5639
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2017

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

Authorized official

Name
Bernard AndohNPI 1952425928
Title
Manager
Phone
(410) 367-5628

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X P04553 MD Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

3716 And One Half W Belverede Ave
Unit C
Baltimore, MD 21215

Mailing address

3716 And One Half W Belverede Ave
Unit C
Baltimore, MD 21215
Phone (410) 367-5628

Other identifiers 2

IdentifierTypeStateIssuer
2038225OtherPK
014324300MedicaidMD

Other names 1

  • BELVEDERE PHARMACY LLC Doing business as

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488240000000",
    "number": "1457475030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 AND ONE HALF W BELVEREDE AVE",
            "address_2": "UNIT C",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21215",
            "telephone_number": "410-367-5628",
            "fax_number": "410-367-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3716 AND ONE HALF W BELVEREDE AVE",
            "address_2": "UNIT C",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21215",
            "telephone_number": "410-367-5628",
            "fax_number": "410-367-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELVEDERE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2017-02-28",
        "status": "A",
        "authorized_official_last_name": "ANDOH",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "410-367-5628"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P04553",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2038225",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014324300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BELVEDERE PHARMACY LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; 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.