MEDICARE: MR. KEVIN MICHAEL NEAREY RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	12904	MD

General Provider Information

NPI Number	:	1598944407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KEVIN MICHAEL NEAREY RPH

Provider Business Mailing Address
First Line	:	710 LISBON CENTER DR STE D
Second Line	:
City	:	WOODBINE
State	:	MD
Zip	:	21797-8629
Country	:	US
Telephone Number	:	410-489-2708
Fax Number	:	410-489-2762

Provider Business Practice Location Address
First Line	:	710 LISBON CENTER DR STE D
Second Line	:
City	:	WOODBINE
State	:	MD
Zip	:	21797-8629
Country	:	US
Telephone Number	:	410-489-2708
Fax Number	:	410-489-2762

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2007
Last Update Date	:	01/19/2021

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