Healthcare Provider Details

I. General information

NPI: 1407442007
Provider Name (Legal Business Name): LINDA MARIE CIMINO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2020
Last Update Date: 12/17/2020
Certification Date: 12/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 CARROLL ISLAND RD
BALTIMORE MD
21220-2208
US

IV. Provider business mailing address

8001 BELLONA AVE
TOWSON MD
21204-1902
US

V. Phone/Fax

Practice location:
  • Phone: 410-335-1135
  • Fax:
Mailing address:
  • Phone: 443-474-2014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14921
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: