Pembrooke Health Services LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PEMBROOKE HEALTH SERVICES LLC

Practice address

11355 Pembrooke SQ Unit 100
Waldorf, MD 20603-4805

Phone

(443) 528-1010

NPI assigned

Aug 4, 2014

Organization subpart

No

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

Authorized official

Name

Jon Habashy

Title

Member/Owner

Phone

(301) 932-7900

Specialties & licenses 1

Addresses

Other names 1

• PEMBROOKE PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607904000000",
    "number": "1699184705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 CENTENNIAL LN",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210426301",
            "telephone_number": "443-528-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11355 PEMBROOKE SQ UNIT 100",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034805",
            "telephone_number": "443-528-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEMBROOKE HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-04",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A",
        "authorized_official_last_name": "HABASHY",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "MEMBER/OWNER",
        "authorized_official_telephone_number": "301-932-7900"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEMBROOKE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PEMBROOKE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Waldorf, MD
• Providers in Waldorf, 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 Dec 14, 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.