Provider Demographics
NPI:1548308216
Name:AMBULATORY CARE PHARMACY INC
Entity type:Organization
Organization Name:AMBULATORY CARE PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO/COO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SINICROPI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-740-9696
Mailing Address - Street 1:9601 BLACKWELL RD
Mailing Address - Street 2:STE 230
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3472
Mailing Address - Country:US
Mailing Address - Phone:301-545-0193
Mailing Address - Fax:301-610-6557
Practice Address - Street 1:9601 BLACKWELL RD STE 230
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3472
Practice Address - Country:US
Practice Address - Phone:301-545-0193
Practice Address - Fax:301-610-6557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
MDP023303336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2036591OtherPK
MD325805000Medicaid