Healthcare Provider Details

I. General information

NPI: 1518101716
Provider Name (Legal Business Name): TOTAL HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2009
Last Update Date: 04/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 W NORTH AVE
BALTIMORE MD
21217-1735
US

IV. Provider business mailing address

1501 DIVISION ST
BALTIMORE MD
21217-3121
US

V. Phone/Fax

Practice location:
  • Phone: 410-735-5378
  • Fax: 410-735-5379
Mailing address:
  • Phone: 410-735-5390
  • Fax: 410-735-5391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336M0003X
TaxonomyManaged Care Organization Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP04998
License Number StateMD

VIII. Authorized Official

Name: WYNDY WEBB
Title or Position: DIRECTOR OF PHARMACY
Credential:
Phone: 410-735-5380