| NPI | 1942538954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA CARNEY Credentialing Coordinator 410-721-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: MD 090087) |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2009-12-02 |