KLC PHARMACY (NPI# 1366769184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366769184 |
| Entity Type | Organization |
| Organization Name | KLC PHARMACY |
| Other Organization Name | MEDMERICA LONG TERM CARE PHARMACY |
| Practice Address |
5602 Baltimore National Pike Ste 100 Baltimore MD 21228-1411 |
| Practice Telephone | 4435525553 |
| Practice Fax Number | 4439556082 |
| Mailing Telephone | 4435525553 |
| Mailing Fax Number | 4439556082 |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2011-08-08 |
| Authorized Official Name | AJAY KHANNA (PRESIDENT) |
| Authorized Official Telephone | 4435525553 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
P05519 | MD | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 2135324 | 01 |
| Other Name | Type Code |
|---|---|
| MEDMERICA LONG TERM CARE PHARMACY | Doing Business As Name - Organization |
| Street Address |
5602 BALTIMORE NATIONAL PIKE STE 100 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21228-1411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992771265 | Delhi Thweatt Jr. | Specialist | 5602 Baltimore National Pike, 300, Baltimore, MD 21228-1411 | 2006-02-27 |
| 1184031676 | Jena Raymond | Counselor | 5602 Baltimore National Pike, Suite 302b, Baltimore, MD 21228-1411 | 2014-07-16 |
| 1184983637 | Phoenix Therapeutic Foundation, Inc | Counselor | 5602 Baltimore National Pike, Suite 700, Baltimore, MD 21228-1411 | 2012-05-03 |
| 1235304189 | Thomas M Burggman | Counselor | 5602 Baltimore National Pike, Suite 508, Baltimore, MD 21228-1411 | 2008-04-22 |
| 1992979025 | Heather N Chapman | Social Worker | 5602 Baltimore National Pike, Suite 508, Baltimore, MD 21228-1411 | 2008-04-18 |
| 1336333079 | Phoenix Therapeutic Foundation | Community/Behavioral Health | 5602 Baltimore National Pike, Suburbia Bldg - Suite # 508/6, Baltimore, MD 21228-1411 | 2007-09-05 |
| 1073713970 | Anthony Alberto Campbell | Social Worker | 5602 Baltimore National Pike, Suite # 506, Baltimore, MD 21228-1411 | 2007-07-19 |
| 1023218997 | Delores Ann Mack | Social Worker | 5602 Baltimore National Pike, Suit # 506, Baltimore, MD 21228-1411 | 2007-07-19 |
| 1447474366 | Theresa Marlene Ridley | Social Worker | 5602 Baltimore National Pike, Baltimore, MD 21228 | 2007-04-12 |
| 1265554315 | Horace Greely Ward Jr. | Obstetrics & Gynecology | 5602 Baltimore National Pike, Suite 600, Baltimore, MD 21228-1411 | 2007-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699307975 | Playful Minds | Social Worker | 1009 Frederick Road, Baltimore, MD 21228 | 2020-02-05 |
| 1649818329 | Resolute Medical Care LLC | Nurse Practitioner | 4 E. Rolling Crossroads, Ste 100, Catonsville, MD 21228 | 2019-12-13 |
| 1760020416 | Bh Brightview Rolling Hills Opco, LLC | Alzheimer Center (Dementia Center) | 848 South Rolling Road, Catonsville, MD 21228 | 2019-12-12 |
| 1912542812 | Tiana Green | Counselor | 606 Edmondson Ave., Catonsville, MD 21228 | 2019-11-14 |
| 1699324806 | Maryland Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 4701 Wilkens Ave, Catonsville, MD 21228 | 2019-09-10 |
| 1528613460 | Hyung Joon Kim Dds PC | Dentist | 516 N. Rolling Rd, #201, Catonsville, MD 21228 | 2019-08-07 |
| 1982109658 | William Jones | Counselor | 29 Tentmill Lane, Pikesville, MD 21228 | 2018-03-26 |
| 1740783752 | Jean Walter Infusion Center, LLC | Clinic/Center | 700 Geipe Road St. 100, Catonsville, MD 21228 | 2018-03-15 |
| 1174036578 | Ideal Telemedicine Services, LLC | Clinic/Center | 516 N Rolling Rd Ste 301, Catonsville, MD 21228 | 2017-11-08 |
| 1932627239 | Mind Over Matter Health Services, Inc. | Community/Behavioral Health | 616 Old Edmondson Ave. Ste. 4, Baltimore, MD 21228 | 2017-09-07 |
| Find all providers in zip 21228 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437498615 | Care One Pharmacy Ltc/specialty Pharmacy | Pharmacy | 2277-2279 Reisterstown Road, Baltimore, MD 21217 | 2013-02-07 |
| 1841442019 | Vita Pharmacy LLC | Pharmacy | 5617 Belair Rd, Baltimore, MD 21206-3619 | 2008-10-18 |
| 1366597825 | Northern Pharmacy and Medical Equipment, LLC | Pharmacy | 7816 Harford Rd, Baltimore, MD 21234 | 2007-01-24 |
| 1902967078 | Anjelo Mida Inc | Pharmacy | 1502 Joh Ave, Ste 100, Baltimore, MD 21227-1137 | 2006-12-13 |
| 1902981293 | America for Better Health Inc | Pharmacy | 219 Collins Ave, Baltimore, MD 21229-3612 | 2006-10-26 |
| 1548728884 | Nomal One, LLC | Pharmacy | 2245 Eastern Ave, Baltimore, MD 21231-3113 | 2019-03-06 |
| 1730559709 | Northern Pharmacy | Pharmacy | 7816 Harford Rd, Baltimore, MD 21234-5850 | 2015-10-02 |
| 1740348457 | Neighborcare Pharmacy Services, Inc. | Pharmacy | 7 E Lee St, Baltimore, MD 21202-6000 | 2006-12-05 |
| 1255408662 | Neighborcare Pharmacy of Va, LLC | Pharmacy | 7 E Lee St, Baltimore, MD 21202-6000 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801494174 | Hpc Health LLC | Pharmacy | 120 E Pulaski Hwy Unit 120, Elkton, MD 21921-6430 | 2020-10-09 |
| 1689209496 | Polaris Pharmacy Services of Maryland, LLC | Pharmacy | 9113 Liberty Rd, Randallstown, MD 21133-3530 | 2020-03-12 |
| 1740791177 | Foers Long Term Care Pharmacy | Pharmacy | 1300 Piccard Dr Ste Ll-16, Rockville, MD 20850-4303 | 2017-10-12 |
| 1114386174 | Smithsburg Pharmacy LLC | Pharmacy | 22030 Jefferson Blvd, Smithsburg, MD 21783-2057 | 2016-02-19 |
| 1356716864 | Northside Pharmacy Long Term Care Inc | Pharmacy | 707 North Bridge Street, Suite C, Elkton, MD 21921 | 2015-12-09 |
| 1043571367 | Nayosha LLC | Pharmacy | 8900 Columbia 100 Pkwy Ste H, Columbia, MD 21045-2336 | 2012-06-04 |
| 1972886927 | Priority Healthcare | Pharmacy | 751 Elkton Blvd, Elkton, MD 21921-5425 | 2011-09-26 |
| 1851523765 | Professional Care Pharmacy Inc | Pharmacy | 806 Reisterstown Rd, Unit 3, Pikesville, MD 21208-4215 | 2009-08-12 |
| 1093941478 | Global Health Pharmacy, Inc | Pharmacy | 7500 Montpelier Rd Ste 106, Laurel, MD 20723-6012 | 2009-05-30 |
| 1649470220 | Partners Pharmacy of Maryland LLC | Pharmacy | 8910 Route 108, Suite C, Columbia, MD 21045-2151 | 2007-07-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.