FIBUS DRUG STORE INC , NPI 1396706891 — BALTIMORE (MD)

NPI 1396706891

14+ Years Experience Organization

FIBUS DRUG STORE INC

04.01.2006
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1396706891
NPI NUMBER

About FIBUS DRUG STORE INC

FIBUS DRUG STORE INC is a provider established in BALTIMORE, MD. The NPI number of FIBUS DRUG STORE INC is 1396706891 and was assigned on 04.01.2006. The practitioners primary taxonomy code is: 3336C0003X .

Mailing address

  • City: BALTIMORE
  • State: MD
  • Postal code: 212162606
  • Phone: 4109471800
  • Fax: 4105669181
  • Address: 2101 GARRISON BLVD

Primary Practice Address

  • Region : BALTIMORE, MD
  • NPI : 1396706891
  • Phone : 4109471800
  • Fax : 4105669181
  • Postalcode : 212162606
  • Address : 2101 GARRISON BLVD

Additional identifiers

  • Identifier: 54920401
  • Code / Type : 1 - other
  • Identifier state : MD
  • Identifier issuer: BLUE CROSS OF MARYLAND

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Provider taxonomy - Pharmacy

  • Taxonomy code: 3336C0003X

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Contacts:

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  • FIBUS DRUG STORE INC
  • Address : 2101 GARRISON BLVD
  • Region : BALTIMORE, MD
  • NPI : 1396706891
  • Phone : 4109471800
  • Fax : 4105669181
  • Postalcode : 212162606

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 4109471800
  • Title or position : PHARMACIST
  • Credentials : BS

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address2101 GARRISON BLVD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameBALTIMORE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameMD
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code212162606
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number4109471800
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number4105669181
The fax number associated with the location address of the provider being identified.
NPI1396706891
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 13336C0003X
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Provider Enumeration Date04.01.2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)FIBUS DRUG STORE INC
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address2101 GARRISON BLVD
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameBALTIMORE
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameMD
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code212162606
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number4109471800
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number4105669181
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameLEVIN
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameNORMAN
The first name of the authorized official
Authorized Official Middle NameLEE
The middle name of the authorized official
Authorized Official Title or PositionPHARMACIST
The title or position of the authorized official
Authorized Official Name Prefix TextMR.
Authorized Official Name Prefix Text
Authorized Official Credential TextBS
Authorized Official Credential Text
Authorized Official Telephone Number4109471800
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #13336C0003X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 154920401
Other Provider Identifier #1
Other Provider Identifier Type 11
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1MD
Other Provider Identifier State #1
Other Provider Identifier Issuer 1BLUE CROSS OF MARYLAND
Other Provider Identifier Issuer #1
X

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