Healthcare Provider Details

I. General information

NPI: 1669608667
Provider Name (Legal Business Name): PACC GROUP INTERNATIONAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2009
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5535 HARFORD RD
BALTIMORE MD
21214-2233
US

IV. Provider business mailing address

PO BOX 11351
BALTIMORE MD
21239-0351
US

V. Phone/Fax

Practice location:
  • Phone: 410-800-4886
  • Fax: 410-864-8941
Mailing address:
  • Phone:
  • Fax: 410-864-8941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number05148
License Number StateMD

VIII. Authorized Official

Name: UCHENNA EKWUNAZU
Title or Position: CHIEF PHARMACIST
Credential: PHARMD
Phone: 410-800-4886