| NPI | 1104974112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE SCHAFFER Dms 410-529-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: MD M42628) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |