Healthcare Provider Details

I. General information

NPI: 1699753541
Provider Name (Legal Business Name): HARFORD PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2006
Last Update Date: 11/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 CONOWINGO RD
BEL AIR MD
21014-1879
US

IV. Provider business mailing address

1510 CONOWINGO RD
BEL AIR MD
21014-1879
US

V. Phone/Fax

Practice location:
  • Phone: 410-838-0990
  • Fax: 410-836-8429
Mailing address:
  • Phone: 410-838-0990
  • Fax: 410-836-8429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP00314
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JAMES TRISTANI
Title or Position: PRES
Credential:
Phone: 410-838-0990