Charlesmead Fountain Pharmcy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P06964 Issued in MD

Legal business name

CHARLESMEAD FOUNTAIN PHARMCY LLC

Doing business as

Charlesmead Pharmacy

Practice address

6242 Bellona Ave
Baltimore, MD 21212-2445

Phone

(410) 435-0210

Fax

(410) 323-5025

NPI assigned

Sep 20, 2006

Last updated

Feb 3, 2016By 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

Mitchell KromskyNPI 1518554534

Title

Owner

Phone

(410) 823-1818

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Charlesmead Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 3

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.

• Mitchell H. Kromsky, PHARM D

  • Pharmacist
  • Towson, MD
  • NPI 1518554534
  NPD Authorized official
• Jeffrey A Rosen, RPH

  • Pharmacist
  • Towson, MD
  • NPI 1033706064

  Community/Retail Pharmacy

  NPD (past)
• Jacqueline C Touse, RPH

  • Pharmacist
  • Baltimore, MD
  • NPI 1235726324
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454457600000",
    "number": "1922105840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6240 BELLONA AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212122408",
            "telephone_number": "410-435-0210",
            "fax_number": "410-323-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6242 BELLONA AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212122445",
            "telephone_number": "410-435-0210",
            "fax_number": "410-323-5025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESMEAD FOUNTAIN PHARMCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-02-03",
        "status": "A",
        "authorized_official_last_name": "KROMSKY",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-823-1818"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P06964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "547107900",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154754",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charlesmead Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly Maria Charles, LMSW
• Sophia Loren Charles
• Tanya Charles, LCPC, NCC
• Toya N Charles, LCSW-C
• Wayne Charles
• Charlestown (out patient rehab)
• Charlestown Community Inc
• Jeneba Lucia Charley, RN
• Charlie's Angel Counseling & Consulting Services, LLC
• Charlie's Angel Counseling & Consulting, LLC

• 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 3, 2016; 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.