Active NPI
Lee Ahlstrom, RPH
- Pharmacist
- Berlin, MD
National Provider Identifier
1902185697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 07472
- Practice address
- 11307 Manklin Creek Rd
Berlin, MD 21811 - Phone
- (410) 208-3811
- NPI assigned
- Aug 11, 2011
- Last updated
- Aug 11, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 07472 | MD | Primary |
Addresses
Primary practice location
11307 Manklin Creek Rd
Berlin, MD 21811
Mailing address
6 Alton PT
Berlin, MD 21811-1739
Phone (410) 208-1249
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07472 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Happy Harrys Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313020800000",
"number": "1902185697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 ALTON PT",
"city": "BERLIN",
"state": "MD",
"postal_code": "218111739",
"telephone_number": "410-208-1249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11307 MANKLIN CREEK RD",
"city": "BERLIN",
"state": "MD",
"postal_code": "21811",
"telephone_number": "410-208-3811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHLSTROM",
"first_name": "LEE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-11",
"last_updated": "2011-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "07472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berlin, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.