NPIMap

Organization Active NPI

Loch Raven Pharmacy Inc

Doing business as Campus Pharmacy

  • Community/Retail Pharmacy
  • Baltimore, MD
National Provider Identifier
1629394192
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P05311 Issued in MD
Legal business name
LOCH RAVEN PHARMACY INC
Doing business as
Campus Pharmacy
Practice address
1101 N Calvert St Unit 3
Baltimore, MD 21202-3840
Phone
(410) 433-9434
Fax
(410) 433-9436
NPI assigned
Apr 9, 2010
Last updated
Oct 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Authorized official

Name
Mr. Anwar Yousuf, PHARMDNPI 1598356412
Title
President
Phone
(410) 323-1515

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X P05311 MD
Community/Retail Pharmacy 3336C0003X P05311 MD Primary

Addresses

Primary practice location

1101 N Calvert St Unit 3
Baltimore, MD 21202-3840

Mailing address

1101 N Calvert St Unit 3
Baltimore, MD 21202-3840
Phone (410) 433-9434

Other identifiers 3

IdentifierTypeStateIssuer
P05311OtherMDPHARMACY PERMIT #
419724100MedicaidMD
D13440565OtherMDSTAE TAX ID #

Other names 1

  • Campus Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

200 W Cold Spring Ln
Baltimore, MD 21210
Phone (410) 662-7977

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1270771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1629394192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N CALVERT ST UNIT 3",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212023840",
            "telephone_number": "410-433-9434",
            "fax_number": "410-433-9436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N CALVERT ST UNIT 3",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212023840",
            "telephone_number": "410-433-9434",
            "fax_number": "410-433-9436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOCH RAVEN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-09",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "YOUSUF",
        "authorized_official_first_name": "ANWAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-323-1515",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MD",
            "license": "P05311",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P05311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY PERMIT #",
            "identifier": "P05311",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "419724100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAE TAX ID #",
            "identifier": "D13440565",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Campus Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Campus Pharmacy",
            "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 Oct 31, 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.