Healthcare Provider Details

I. General information

NPI: 1871246413
Provider Name (Legal Business Name): ALLIANCE PHARMACY PLUS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2022
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 ANNAPOLIS RD
BALTIMORE MD
21227-1120
US

IV. Provider business mailing address

3400 ANNAPOLIS RD
BALTIMORE MD
21227-1120
US

V. Phone/Fax

Practice location:
  • Phone: 443-869-2512
  • Fax: 443-869-2709
Mailing address:
  • Phone: 443-869-2512
  • Fax: 443-869-2709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. EMEKA KENNETH MUNONYE
Title or Position: PHARMACIST
Credential: RPH
Phone: 310-489-9982