Laurel Main Street Pharmacy Incorporated

Primary specialty

PharmacistTaxonomy code 183500000X

License

16959 Issued in MD

Legal business name

LAUREL MAIN STREET PHARMACY INCORPORATED

Practice address

667 Main St
Laurel, MD 20707-4067

Phone

(301) 317-3838

Fax

(301) 317-3637

NPI assigned

Jun 18, 2005

Organization subpart

No

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

Authorized official

Name

Ali H Thakkar

Title

Owner

Phone

(301) 317-3838

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Main Street Pharmacy Doing business as

Electronic endpoints 1

Tax ID family

Laurel Main Street Pharmacy Incorporated3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Laurel Main Street Pharmacy

  • Long Term Care Pharmacy
  • Laurel, MD
  • NPI 1043968530
  NPD tax ID
• Laurel Main Street Pharmacy Incorporated

  • Community/Retail Pharmacy
  • Laurel, MD
  • NPI 1023058690
  NPD tax ID

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

{
    "created_epoch": "1119052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1477558112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 MAIN ST",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074067",
            "telephone_number": "301-317-3838",
            "fax_number": "301-317-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 MAIN ST",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074067",
            "telephone_number": "301-317-3838",
            "fax_number": "301-317-3637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "653 Main St",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MD",
            "postal_code": "207074067",
            "country_code": "US",
            "telephone_number": "301-317-3838",
            "fax_number": "301-317-3637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAUREL MAIN STREET PHARMACY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-18",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "THAKKAR",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-317-3838"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "16959",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0029793",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "2132087",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "info@msrxlaurel.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "667 Main St",
            "city": "Laurel",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207074067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Main Street Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Main Street Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacist in Laurel, MD
• Providers in Laurel, MD by specialty
• Pharmacist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.