Healthcare Provider Details

I. General information

NPI: 1285012765
Provider Name (Legal Business Name): MERGOLD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2015
Last Update Date: 05/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 FRANCIS AVE
BALTIMORE MD
21227-3913
US

IV. Provider business mailing address

1307 FRANCIS AVE
BALTIMORE MD
21227-3913
US

V. Phone/Fax

Practice location:
  • Phone: 410-247-3344
  • Fax: 410-247-9110
Mailing address:
  • Phone: 410-247-3344
  • Fax: 410-247-9110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License NumberP02423
License Number StateMD

VIII. Authorized Official

Name: GEORGE D GARMER
Title or Position: OWNER/VICE PRESIDENT
Credential: RPH
Phone: 410-247-3344