| NPI | 1245397678 |
|---|---|
| Doing Business As | ST JOHNS PROGRESSIVE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | LEO MALLARD Owner 410-741-5150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MD P01320) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2012-12-26 |