Healthcare Provider Details

I. General information

NPI: 1972581825
Provider Name (Legal Business Name): SOMERSET HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2006
Last Update Date: 03/07/2023
Certification Date: 10/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 W MAIN ST UNIT A
CRISFIELD MD
21817
US

IV. Provider business mailing address

390 W MAIN ST
CRISFIELD MD
21817-1329
US

V. Phone/Fax

Practice location:
  • Phone: 410-968-1660
  • Fax: 410-968-9102
Mailing address:
  • Phone: 410-968-1660
  • Fax: 410-968-9102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14326
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP04174
License Number StateMD

VIII. Authorized Official

Name: MR. SHAH MOHAMMED YAHYA
Title or Position: VICE PRESIDENT
Credential: RP.H
Phone: 410-968-1660