Healthcare Provider Details

I. General information

NPI: 1891898722
Provider Name (Legal Business Name): NORTHERN PHARMACY AND MEDICAL EQUIPMENT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 12/01/2020
Certification Date: 12/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6703-6705 HARFORD RD.
BALTIMORE MD
21234-7707
US

IV. Provider business mailing address

6701 HARFORD RD
BALTIMORE MD
21234-7721
US

V. Phone/Fax

Practice location:
  • Phone: 410-254-2055
  • Fax: 410-843-7743
Mailing address:
  • Phone: 410-254-2055
  • Fax: 410-843-7743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License NumberPW0245
License Number StateMD

VIII. Authorized Official

Name: PEPPER K MINTZ
Title or Position: PRESIDENT AND COO
Credential:
Phone: 410-254-2055