Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 333600000X | Pharmacy | | NRX0001118 | DISTRICT OF COLUMBIA | No |
| 2 | 3336H0001X | Pharmacy | Home Infusion Therapy Pharmacy | | | No |
| 3 | 3336S0011X | Pharmacy | Specialty Pharmacy | PO6148 | MARYLAND | No |
| 4 | 3336S0011X | Pharmacy | Specialty Pharmacy | 1053 | NEBRASKA | No |
| 5 | 3336S0011X | Pharmacy | Specialty Pharmacy | 4200 | IOWA | No |
| 6 | 3336S0011X | Pharmacy | Specialty Pharmacy | 0214001769 | VIRGINIA | No |
| 7 | 3336S0011X | Pharmacy | Specialty Pharmacy | 12735 | NORTH CAROLINA | No |
| 8 | 3336S0011X | Pharmacy | Specialty Pharmacy | 022-032200 | NEW YORK | No |
| 9 | 3336S0011X | Pharmacy | Specialty Pharmacy | NP000133 | PENNSYLVANIA | No |
| 10 | 3336S0011X | Pharmacy | Specialty Pharmacy | 17174 | SOUTH CAROLINA | No |
| 11 | 3336S0011X | Pharmacy | Specialty Pharmacy | 28RS00706300 | NEW JERSEY | Yes |
| 12 | 3336S0011X | Pharmacy | Specialty Pharmacy | PCN-0002571 | CONNECTICUT | No |
| 13 | 3336S0011X | Pharmacy | Specialty Pharmacy | PHN11258 | RHODE ISLAND | No |
| 14 | 3336S0011X | Pharmacy | Specialty Pharmacy | 36.018647 | VERMONT | No |
| 15 | 3336S0011X | Pharmacy | Specialty Pharmacy | 5301010582 | MICHIGAN | No |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 5240085 00 | MEDICAID | MARYLAND | |
| 2 | 1026741160001 | MEDICAID | PENNSYLVANIA | |
| 3 | 1619296761 | MEDICAID | NORTH CAROLINA | |
| 4 | 7N6300 | MEDICAID | SOUTH CAROLINA | |
| 5 | 0245691 | MEDICAID | NEW JERSEY | |
| 6 | 2125729 | OTHER | | PK |