| NPI | 1811207079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIESER MAYO Director Of Pharmacy 410-554-2907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: MD P00797) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: MD P00797) |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2010-10-20 |