Healthcare Provider Details

I. General information

NPI: 1962563437
Provider Name (Legal Business Name): BARBARA BEATRICE BEDELL PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 S 5TH AVE
DENTON MD
21629-1368
US

IV. Provider business mailing address

508 S 5TH AVE
DENTON MD
21629-1368
US

V. Phone/Fax

Practice location:
  • Phone: 410-479-1100
  • Fax: 410-479-1240
Mailing address:
  • Phone: 410-479-1100
  • Fax: 410-479-1240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number09783
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: