Healthcare Provider Details

I. General information

NPI: 1700126281
Provider Name (Legal Business Name): BARBARA ANN MCCULLERS CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2013
Last Update Date: 02/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 W PRATT ST
BALTIMORE MD
21223-2665
US

IV. Provider business mailing address

1251 W PRATT ST
BALTIMORE MD
21223-2665
US

V. Phone/Fax

Practice location:
  • Phone: 410-209-1100
  • Fax: 410-209-4500
Mailing address:
  • Phone: 410-209-1100
  • Fax: 410-209-4500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberT09126
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: