Healthcare Provider Details

I. General information

NPI: 1205140365
Provider Name (Legal Business Name): AKWASI NKANSAH RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2010
Last Update Date: 08/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7153 SECURITY BLVD
BALTIMORE MD
21244-1811
US

IV. Provider business mailing address

7153 SECURITY BLVD
BALTIMORE MD
21244-1811
US

V. Phone/Fax

Practice location:
  • Phone: 410-944-6400
  • Fax: 410-944-2492
Mailing address:
  • Phone: 410-944-6400
  • Fax: 410-944-2492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13933
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: