Koulward Health LLC Population Health Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

KOULWARD HEALTH LLC POPULATION HEALTH PHARMACY

Doing business as

st. Joseph medical Center Pharmacy

Practice address

7505 Osler Dr
Towson, MD 21204-7736

Phone

(443) 279-1998

Fax

(443) 895-4554

NPI assigned

Jun 19, 2019

Last updated

Apr 23, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

KOULWARD HEALTH LLC POPULATION HEALTH PHARMACYAs reported in NPPES

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

Authorized official

Name

Mr. Syam Potluri

Title

Managing Member

Phone

(443) 823-3350

Specialties & licenses 1

Addresses

Other names 1

• st. Joseph medical Center Pharmacy Doing business as

Part of

Koulward Health LLC

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Scylex Inc

  dba Scylexlab

  • Clinical Molecular Genetics Physician
  • Columbia, MD
  • NPI 1629843875

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587600000000",
    "number": "1518527704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7505 OSLER DR",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047736",
            "telephone_number": "443-279-1998",
            "fax_number": "443-895-4554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7505 OSLER DR",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047736",
            "telephone_number": "443-279-1998",
            "fax_number": "443-895-4554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOULWARD HEALTH LLC POPULATION HEALTH PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KOULWARD HEALTH LLC POPULATION HEALTH PHARMACY",
        "enumeration_date": "2019-06-19",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A",
        "authorized_official_last_name": "POTLURI",
        "authorized_official_first_name": "SYAM",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "443-823-3350",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "st. Joseph medical Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "st. Joseph medical Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robin Genendlis Korotki, P.T.
• Stephanie Brooke Kors, PHD
• Samuel Anthony Kosinski, MD
• Elaine Tina Koukoulas, M.D.
• Koulward Health LLC Population Health Pharmacy (Sjmc Pharmacy St. Joseph Medical Center Pharmacy)
• Amanda Kountz
• Scott Kover, NCMT, LDT
• Thomas F Krajewski, M.D.
• Marta Krajniak, PH.D.
• Tessa Kranski, PHD

• Community/Retail Pharmacy in Towson, MD
• Providers in Towson, 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 Apr 23, 2020; 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.