Healthcare Provider Details

I. General information

NPI: 1124394432
Provider Name (Legal Business Name): REFUA PHARMACY AND MEDICAL SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2012
Last Update Date: 01/09/2023
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6404 REISTERSTOWN RD
BALTIMORE MD
21215-2308
US

IV. Provider business mailing address

6404 REISTERSTOWN RD
BALTIMORE MD
21215-2308
US

V. Phone/Fax

Practice location:
  • Phone: 410-585-0055
  • Fax: 410-585-0222
Mailing address:
  • Phone: 410-585-0055
  • Fax: 410-585-0222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP05671
License Number StateMD

VIII. Authorized Official

Name: ALEXANDER ALTSHULER
Title or Position: PHARMACY MANAGER
Credential: BS IN PHARMACY
Phone: 410-585-0055