| NPI | 1457394108 |
|---|---|
| Doing Business As | PROFESSIONAL PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JOHN WAYNE Pharmacist And Owner 410-687-8113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MD P04404) |
| Additional Taxonomies | 333600000X Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2016-11-16 |