Provider Demographics
NPI:1902913163
Name:LAWSON INC
Entity Type:Organization
Organization Name:LAWSON INC
Other - Org Name:THE MEDICINE SHOPPE 1300
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HART-LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH PHARM D BS PHARM
Authorized Official - Phone:301-341-1779
Mailing Address - Street 1:PO BOX 5223
Mailing Address - Street 2:
Mailing Address - City:UPPER MALBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20775
Mailing Address - Country:US
Mailing Address - Phone:301-341-1779
Mailing Address - Fax:301-341-1523
Practice Address - Street 1:6425 LANDOVER RD
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785
Practice Address - Country:US
Practice Address - Phone:301-341-1779
Practice Address - Fax:301-341-1523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP018143336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2119534OtherNABP