Healthcare Provider Details

I. General information

NPI: 1205876141
Provider Name (Legal Business Name): ECUMED INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6719 REISTERSTOWN RD
BALTIMORE MD
21215-2417
US

IV. Provider business mailing address

432 EASTERN BLVD.
BALTIMORE MD
21221-5714
US

V. Phone/Fax

Practice location:
  • Phone: 410-358-4600
  • Fax:
Mailing address:
  • Phone: 410-633-6200
  • Fax: 410-633-7559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP02078
License Number StateMD

VIII. Authorized Official

Name: MR. BARTON ARONSON
Title or Position: PRESIDENT/ CEO
Credential:
Phone: 410-633-6200