Rehoboth Healthcare Services

Primary specialty

PharmacyTaxonomy code 333600000X

License

P07055 Issued in MD

Legal business name

REHOBOTH HEALTHCARE SERVICES

Doing business as

Owings Mills Pharmacy

Practice address

10085 Red Run Blvd Ste 104
Suite 104
Owings Mills, MD 21117-4811

Phone

(443) 352-3818

Fax

(443) 379-0051

NPI assigned

Apr 19, 2016

Organization subpart

No

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

Authorized official

Name

Jean Tanon

Title

Director

Phone

(443) 352-3818

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• Owings Mills Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472774400000",
    "number": "1790139442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10085 RED RUN BLVD",
            "address_2": "SUITE 104",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174836",
            "telephone_number": "443-352-3818",
            "fax_number": "443-379-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10085 RED RUN BLVD STE 104",
            "address_2": "SUITE 104",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174811",
            "telephone_number": "443-352-3818",
            "fax_number": "443-379-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHOBOTH HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-19",
        "last_updated": "2016-09-02",
        "status": "A",
        "authorized_official_last_name": "TANON",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "443-352-3818"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MD",
            "license": "P07055",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2159837",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1087894",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Owings Mills Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Pharmacy in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.