VD & Sr Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P06708 Issued in MD

Legal business name

VD & SR PHARMACY LLC

Practice address

1535 Park Ave
Baltimore, MD 21217-4280

Phone

(410) 225-0800

Fax

(410) 523-3434

NPI assigned

Oct 20, 2006

Organization subpart

No

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

Authorized official

Name

Syam Potluri, RPH

Title

Managing Member

Phone

(443) 823-3350

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• PARK AVENUE PHARMACY Doing business as

Practitioners 2

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

• Steve Mavronis, PHARMACIST

  • Pharmacist
  • Baltimore, MD
  • NPI 1003573023
  NPD (past)
• Tariq Syed

  • Pharmacist
  • Baltimore, MD
  • NPI 1366965279
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487116800000",
    "number": "1821170614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 PARK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212174280",
            "telephone_number": "410-225-0800",
            "fax_number": "410-523-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 PARK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212174280",
            "telephone_number": "410-225-0800",
            "fax_number": "410-523-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VD & SR PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2017-02-15",
        "status": "A",
        "authorized_official_last_name": "POTLURI",
        "authorized_official_first_name": "SYAM",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "443-823-3350",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P06708",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "991042600",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2150056",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PARK AVENUE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tina Vaziri
• Zulimar Vazquez Fontanez
• Alexandra Yulissa Vazquez, RN
• Juan Pablo Vazquez, MD
• Sara Anne Vazquez, LCSW-C
• VDN Pharmacy LLC
• VDN Pharmacy LLC
• VDNR Infusion Services LLC
• Matthew Seth Veader
• Tricia Vecchione, MD

• Community/Retail Pharmacy in Baltimore, MD
• Providers in Baltimore, 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 Feb 15, 2017; 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.