Healthcare Provider Details

I. General information

NPI: 1538174164
Provider Name (Legal Business Name): LLODNA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 05/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 GARRISON BLVD STE 209
BALTIMORE MD
21216-2335
US

IV. Provider business mailing address

C/O LLODNA INC 1700 EDMONDSON AVE
BALTIMORE MD
21223
US

V. Phone/Fax

Practice location:
  • Phone: 410-233-8666
  • Fax: 410-233-8664
Mailing address:
  • Phone:
  • Fax:

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 NumberPO4455
License Number StateMD

VIII. Authorized Official

Name: MICHELLE ANDOLL
Title or Position: PHARMACIST
Credential: RPH
Phone: 410-523-5900