| NPI | 1679888655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NGUEGNI FOBI-TAKUSI Director Of Pharmacy 410-363-8271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MD P05380) |
| Additional Taxonomies | 3336M0003X Pharmacy Managed Care Organization Pharmacy |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2014-07-02 |