Healthcare Provider Details

I. General information

NPI: 1740994060
Provider Name (Legal Business Name): AUSTINS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29509 CANVASBACK DR STE 100
EASTON MD
21601-7163
US

IV. Provider business mailing address

10757 YORK RD
COCKEYSVILLE MD
21030-2114
US

V. Phone/Fax

Practice location:
  • Phone: 410-770-0300
  • Fax: 410-770-0302
Mailing address:
  • Phone: 410-773-0300
  • Fax: 410-773-0302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DONNA WOLK
Title or Position: CEO
Credential: PHD
Phone: 410-773-0300