Healthcare Provider Details
I. General information
NPI: 1649196528
Provider Name (Legal Business Name): MOSKOS GEORGIOS TSAKIRIS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1717 E MONUMENT ST
BALTIMORE MD
21287-0027
US
IV. Provider business mailing address
1717 E MONUMENT ST
BALTIMORE MD
21287-0027
US
V. Phone/Fax
- Phone: 410-955-0055
- Fax: 410-614-7114
- Phone: 410-955-0055
- Fax: 410-614-7114
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 12179 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: