Healthcare Provider Details

I. General information

NPI: 1700342896
Provider Name (Legal Business Name): MENDEL PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2019
Last Update Date: 02/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9131 PISCATAWAY RD STE 200
CLINTON MD
20735-2578
US

IV. Provider business mailing address

9131 PISCATAWAY RD STE 200
CLINTON MD
20735-2578
US

V. Phone/Fax

Practice location:
  • Phone: 301-242-3190
  • Fax: 301-242-3198
Mailing address:
  • Phone: 301-242-3190
  • Fax: 301-242-3198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOHN NNAMDI ONYEACHONAM
Title or Position: PRESIDENT AND CEO
Credential: PHARM D , R.PH
Phone: 301-735-2221