Healthcare Provider Details

I. General information

NPI: 1841580933
Provider Name (Legal Business Name): HEATHER ANN HURLEY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2011
Last Update Date: 04/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S GREENE ST
BALTIMORE MD
21201-1544
US

IV. Provider business mailing address

29 S GREENE ST SUITE 400
BALTIMORE MD
21201-1504
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-3441
  • Fax: 410-328-6781
Mailing address:
  • Phone: 410-328-3441
  • Fax: 410-328-6781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2001023397
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number17640
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: