Civic Health Services LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P04859 Issued in MD

Legal business name

CIVIC HEALTH SERVICES LLC

Doing business as

Mt Hermon Discount Pharmacy

Practice address

1207 Mount Hermon Rd
Salisbury, MD 21804-5111

Phone

(410) 749-5900

Fax

(410) 749-5901

NPI assigned

Nov 27, 2008

Last updated

Jul 19, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Waheed Aziz, BSNPI 1184908337

Title

Pharmacist

Phone

(410) 430-8500

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• MT HERMON DISCOUNT PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in MD2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Waheed Aziz, RPH, M.S

  • Pharmacist
  • Salisbury, MD
  • NPI 1184908337
  NPD Authorized official
• Ganiyu Mumuney, RPH

  • Pharmacist
  • Salisbury, MD
  • NPI 1609631126
  NPD (past)

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

{
    "created_epoch": "1227744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1861647216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 MOUNT HERMON RD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218045111",
            "telephone_number": "410-749-5900",
            "fax_number": "410-749-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 MOUNT HERMON RD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218045111",
            "telephone_number": "410-749-5900",
            "fax_number": "410-749-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIVIC HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-27",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "AZIZ",
        "authorized_official_first_name": "WAHEED",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "410-430-8500",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P04859",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020248700",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2118209",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MT HERMON DISCOUNT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Y Chung, M.D.
• Traci Ann Church, CRNP
• Zachary Chylinski, LGPC
• Joseph Alan Cinderella, M.D.
• City of Salisbury
• Rachel Zipporah Clark, CRNP
• Amanda Clarke, CRNP
• Nattile Clarke, FNP-BC
• Donald E. Clayton, CRNP-F
• Jerry James Clayville, CRNP

• Community/Retail Pharmacy in Salisbury, MD
• Providers in Salisbury, 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 Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.