CHARLOTTE HALL PHARMACY
NPI 1356749592
Pharmacy - Long Term Care Pharmacy in Charlotte Hall, MD

Q: What is Pruitthealth Pharmacy Services - Charlotte Hall, Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Long Term Care Pharmacy, with taxonomy code 3336L0003X.

Active since December 19, 2014

29449 CHARLOTTE HALL RD, CHARLOTTE HALL, MD 20622(704) 548-7730 Get Directions Write a Review

NPPES record last updated: April 24, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 24, 2024, Jan 19, 2021, Jan 13, 2017 (3 updates tracked since 2017).

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About Charlotte Hall Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLOTTE HALL PHARMACY (NPI 1356749592) is a healthcare organization registered as a long term care pharmacy in Charlotte Hall, Maryland and active in the NPI registry since December 2014. The organization lists Lynethia N Holley, Provider Enrollment Specialist, as its authorized official.

NPPES Registry Identity

NPI1356749592

Entity TypeOrganization

Primary Taxonomy3336L0003X

Legal Business NamePRUITTHEALTH PHARMACY SERVICES - CHARLOTTE HALL, INC

Location Address29449 CHARLOTTE HALL RDCharlotte Hall, MD 20622

Mailing Address1626 Jeurgens CtNorcross, GA 30093 · (770) 279-6200 · Fax (833) 679-5232

Phone(704) 548-7730

Organization SubpartNo

Authorized OfficialLynethia N HolleyProvider Enrollment Specialist · (770) 506-6875

Enumeration DateDecember 19, 2014

Last NPPES UpdateApril 24, 20243 updates tracked since enumeration

NPPES CertifiedApril 23, 2024

✔ NPI 1356749592 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Long Term Care PharmacySuppliers

Taxonomy Code3336L0003X

Definition

A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

29449 CHARLOTTE HALL RD, Charlotte Hall, MD 20622

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Other Names 1

Doing Business AsCharlotte Hall Pharmacy

Other Identifiers 2

OtherPW0548MD · State License

Medicaid269091800MD

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PRUITTHEALTH THERAPY SERVICES, INC.

Clinic/Center (Physical Therapy)