Healthcare Provider Details

I. General information

NPI: 1073508271
Provider Name (Legal Business Name): VOSHELL'S PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 WILKENS AVE STE 103
BALTIMORE MD
21229-5204
US

IV. Provider business mailing address

3455 WILKENS AVE STE 103
BALTIMORE MD
21229-5204
US

V. Phone/Fax

Practice location:
  • Phone: 410-644-8400
  • Fax: 410-368-5110
Mailing address:
  • Phone: 410-644-8400
  • Fax: 410-368-5110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP00941
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier2033789
Identifier TypeOTHER
Identifier State
Identifier IssuerPK
# 2
Identifier095902200
Identifier TypeMEDICAID
Identifier StateMD
Identifier Issuer
# 3
Identifier412108200
Identifier TypeMEDICAID
Identifier StateMD
Identifier Issuer

VIII. Authorized Official

Name: TRIEU BAO
Title or Position: PRESIDENT
Credential:
Phone: 410-644-8400