NPIMap

Organization Active NPI

Northwest Hospital Center Inc

Doing business as The LifeBridge Pharmacy at Northwest Hospital

  • Community/Retail Pharmacy
  • Randallstown, MD
National Provider Identifier
1730479080
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P05509 Issued in MD
Legal business name
NORTHWEST HOSPITAL CENTER INC
Doing business as
The LifeBridge Pharmacy at Northwest Hospital
Practice address
5401 Old Court Rd
Randallstown, MD 21133-5103
Phone
(410) 701-4455
Fax
(410) 701-4422
NPI assigned
Apr 7, 2011
Last updated
Oct 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Authorized official

Name
David McCormick, PHARM D.
Title
Avp
Phone
(410) 701-4618

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X P05509 MD Primary

Addresses

Primary practice location

5401 Old Court Rd
Randallstown, MD 21133-5103

Mailing address

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (410) 701-4455

Other identifiers 2

IdentifierTypeStateIssuer
2130052OtherPK
418994000MedicaidMD

Other names 1

  • The LifeBridge Pharmacy at Northwest Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northwest Hosp Ctr Card11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634688000000",
    "number": "1730479080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 OLD COURT RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335103",
            "telephone_number": "410-701-4455",
            "fax_number": "410-701-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 OLD COURT RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335103",
            "telephone_number": "410-701-4455",
            "fax_number": "410-701-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST HOSPITAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-07",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "AVP",
        "authorized_official_telephone_number": "410-701-4618",
        "authorized_official_credential": "PHARM D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P05509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2130052",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "418994000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The LifeBridge Pharmacy at Northwest Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The LifeBridge Pharmacy at Northwest Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Randallstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.