Healthcare Provider Details

I. General information

NPI: 1710357454
Provider Name (Legal Business Name): ANNA EINWALTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2015
Last Update Date: 10/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11729 BELTSVILLE DR
BELTSVILLE MD
20705-3147
US

IV. Provider business mailing address

9106 SANDRA CT
RANDALLSTOWN MD
21133-3317
US

V. Phone/Fax

Practice location:
  • Phone: 888-694-7287
  • Fax:
Mailing address:
  • Phone: 443-675-8274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21634
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: