Healthcare Provider Details

I. General information

NPI: 1154366615
Provider Name (Legal Business Name): FINKSBURG PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 03/31/2020
Certification Date: 03/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2027 SUFFOLK RD STE 4
FINKSBURG MD
21048-1634
US

IV. Provider business mailing address

2027 SUFFOLK RD STE 4
FINKSBURG MD
21048-1634
US

V. Phone/Fax

Practice location:
  • Phone: 410-526-1055
  • Fax: 410-526-5211
Mailing address:
  • Phone: 410-526-1055
  • Fax: 410-526-5211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP03165
License Number StateMD

VIII. Authorized Official

Name: RAIMON CARY
Title or Position: PHARMACY MANAGER
Credential:
Phone: 410-526-1055