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Contact Information

SHOPRITE OF LIBERTY HEIGHTS, LLC
4601 LIBERTY HEIGHTS AVE
BALTIMORE, MD21207-7553
 Phone: 410-367-1850
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinic Pharmacy

3336C0002X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for SHOPRITE OF LIBERTY HEIGHTS, LLC

NPI # 1306476106
LBN Legal business name SHOPRITE OF LIBERTY HEIGHTS, LLC
Authorized official FRANK HENDERSON - (PHARMACY DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/21/2020
Last updated 01/21/2020 - About 6 years ago
Identifiers
MD Medicaid 079663800
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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