Halethorpe Drug Immunization LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

P02423 Issued in MD

Legal business name

HALETHORPE DRUG IMMUNIZATION LLC

Doing business as

Halethorpe Pharmacy

Practice address

1307 Francis Ave
Baltimore, MD 21227-3913

Phone

(410) 247-3344

Fax

(410) 247-9110

NPI assigned

May 21, 2014

Last updated

May 21, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

MERGOLD INCAs reported in NPPES

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

Authorized official

Name

Mr. George Garmer, RPH

Title

V.P.

Phone

(410) 207-5751

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Halethorpe Pharmacy Doing business as

Part of

Mergold Inc

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400630400000",
    "number": "1992117279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 FRANCIS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212273913",
            "telephone_number": "410-247-3344",
            "fax_number": "410-247-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 FRANCIS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212273913",
            "telephone_number": "410-247-3344",
            "fax_number": "410-247-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALETHORPE DRUG IMMUNIZATION LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERGOLD INC",
        "enumeration_date": "2014-05-21",
        "last_updated": "2014-05-21",
        "status": "A",
        "authorized_official_last_name": "GARMER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "V.P.",
        "authorized_official_telephone_number": "410-207-5751",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MD",
            "license": "P02423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "241004400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Halethorpe Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Breauna Halford, RN

• Pharmacy in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Pharmacy in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; 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.