Accokeek Drug and Health Care Inc
Organization Active NPI Community/Retail Pharmacy · Accokeek, MD
NPI 1689620262 · NPPES record last updated Aug 21, 2024
Key facts
- NPI
- 1689620262
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- P02491 (MD)
- Legal business name
- ACCOKEEK DRUG AND HEALTH CARE INC
- Practice address
- 15789 Livingston Rd Unit 108
Accokeek, MD 20607-3345 - Phone
- (301) 203-7205
- Fax
- (301) 203-7207
- NPI assigned
- May 26, 2006
- Organization subpart
- No
Authorized official
- Name
- Joseph W Penzenstadler, RPH
- Title
- President
- Phone
- (301) 203-7205
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110309000297 | DC | Part B Supplier - Mass Immunization (Roster Biller Only) | 6608986765 | Practice locations: Accokeek, MD |
National Provider Directory
Locations
15789 Livingston Rd
Unit 108
Accokeek, MD 20607
Phone (301) 203-7205
12114 Old Line Ctr
Waldorf, MD 20602
Phone (301) 396-9277
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | P02491 | MD | |
| Community/Retail Pharmacy | 3336C0003X | P02491 | MD | Yes |
Addresses
Primary practice location
15789 Livingston Rd Unit 108
Accokeek, MD 20607-3345
Mailing address
15789 Livingston Rd Unit 108
Accokeek, MD 20607-3345
Phone (301) 203-7205
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 720500700 | Medicaid | MD |
Other providers in Accokeek, MD
- A Plus Enhancements Educational Services, LLC
- Accokeek Home Care Services, LLC
- Patricia W Achama
- Omolara Adekanmi
- Joannah K Adeyeye
- Aim Healthcare
All providers in Accokeek, MD · Community/Retail Pharmacy in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.