| Main Street Pharmacy | |
|
667 Main St Laurel MD 20707-4067 | |
| (301) 317-3838 | |
| (301) 317-3637 |
| Full Name | Main Street Pharmacy |
|---|---|
| Speciality | Pharmacy - Long Term Care Pharmacy |
| Location | 667 Main St, Laurel, Maryland |
| Authorized Official Name and Position | Ali H Thakkar (OWNER) |
| Authorized Official Contact | 3013173838 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Pharmacy 667 Main St Laurel MD 20707-4067 Ph: (301) 317-3838 | Main Street Pharmacy 667 Main St Laurel MD 20707-4067 Ph: (301) 317-3838 |
| NPI Number | 1043968530 |
|---|---|
| Provider Enumeration Date | 03/14/2022 |
| Last Update Date | 05/20/2025 |
| Certification Date | 05/20/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043968530 | NPI | - | NPPES |
| 037359100 | Medicaid | DC | |
| 443806000 | Medicaid | MD | |
| 336716900 | Medicaid | MD |
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