Craig'S Drug Store, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P00094 Issued in MD

Legal business name

CRAIG'S DRUG STORE, INC.

Practice address

409 Race St
Cambridge, MD 21613-1835

Phone

(410) 228-3322

Fax

(410) 228-3666

NPI assigned

Aug 10, 2005

Organization subpart

No

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

Authorized official

Name

Charles Kelly, BS

Title

Owner

Phone

(410) 228-3322

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Craig's Drug Store, Inc. Doing business as

Medicare fee-for-service enrollment

Enrolled in MD2 enrollments

Enrollment records 2

Tax ID family

Craigs Drug Store Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Craig'S Drug Store, Inc.

  • Community/Retail Pharmacy
  • Cambridge, MD
  • NPI 1447003769
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Craig'S Drug Store, Inc.

  • Community/Retail Pharmacy
  • Cambridge, MD
  • NPI 1447003769
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacquelyn D Kelly, PHARMD

  • Pharmacist
  • Cambridge, MD
  • NPI 1629946140
  NPD

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1821090804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 RACE ST",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216131835",
            "telephone_number": "410-228-3322",
            "fax_number": "410-228-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 RACE ST",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216131835",
            "telephone_number": "410-228-3322",
            "fax_number": "410-228-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAIG'S DRUG STORE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-10",
        "last_updated": "2025-09-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-228-3322",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P00094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038852100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2033040",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Craig's Drug Store, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Cambridge, MD
• Community/Retail Pharmacy in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.