Physicians RX Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P06366 Issued in MD

Legal business name

PHYSICIANS RX PHARMACY LLC

Practice address

9701 Apollo Dr Ste 400
Largo, MD 20774-4791

Phone

(301) 477-3367

Fax

(866) 354-1868

NPI assigned

Jan 22, 2013

Organization subpart

No

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

Authorized official

Name

Chris Wakefield

Title

Corporate Manager

Phone

(412) 477-7803

Specialties & licenses 4

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Tax ID family

Physicians RX Pharmacy LLC3 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.

• Physicians RX Pharmacies

  • Pharmacist
  • Greenbelt, MD
  • NPI 1710335187
  NPD tax ID
• Physicians RX Pharmacy LLC

  • Pharmacy
  • Largo, MD
  • NPI 1770322745
  NPD tax ID

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

{
    "created_epoch": "1358812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712793600000",
    "number": "1710225008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9701 APOLLO DR STE 400",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744791",
            "telephone_number": "301-477-3367",
            "fax_number": "866-354-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 APOLLO DR STE 400",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744791",
            "telephone_number": "301-477-3367",
            "fax_number": "866-354-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS RX PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-22",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A",
        "authorized_official_last_name": "WAKEFIELD",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "CORPORATE MANAGER",
        "authorized_official_telephone_number": "412-477-7803"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IL",
            "license": "054.018661",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P06366",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "DC",
            "license": "NRX0000450",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2139016",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "549920800",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59780800",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "465033443001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tasha Renee Phillips-Wilson, MD, MS
• Jacob William Phillips, D.O.
• Yvette Darnell Phillips, LGSW
• Carolyn Dorothea Philson, BSN, RN, CDE
• Physical & Sports Rehab Inc
• Physicians RX Pharmacy LLC
• Pinnacle Enrichment Healthcare Services, LLC
• Bahram Pishdad, M.D.
• Cydnye Pittman
• Donna M Pittman, MD

• Community/Retail Pharmacy in Largo, MD
• Providers in Largo, 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 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.