Healthcare Provider Details

I. General information

NPI: 1265447882
Provider Name (Legal Business Name): THREE STAR BUSINESS ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 06/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 ORVILLE RD
BALTIMORE MD
21221-1309
US

IV. Provider business mailing address

163 ORVILLE RD
BALTIMORE MD
21221-1309
US

V. Phone/Fax

Practice location:
  • Phone: 410-686-1136
  • Fax: 410-686-1211
Mailing address:
  • Phone: 410-686-1136
  • Fax: 410-686-1211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP04197
License Number StateMD

VIII. Authorized Official

Name: AZIZ NASIR
Title or Position: PRESIDENT
Credential:
Phone: 410-686-1136