Healthcare Provider Details

I. General information

NPI: 1164104147
Provider Name (Legal Business Name): MASON JOSEPH MYERS PHARMD, BCOP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 NORTH WOLFE STREET CARNEGIE BLDG ROOM 180
BALTIMORE MD
21287
US

IV. Provider business mailing address

1402 POINT ST UNIT 2311
BALTIMORE MD
21231-3946
US

V. Phone/Fax

Practice location:
  • Phone: 330-720-3890
  • Fax:
Mailing address:
  • Phone: 702-816-1644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH-0019609
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number30439
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: