Healthcare Provider Details

I. General information

NPI: 1750797056
Provider Name (Legal Business Name): TAMIKA GREENWOOD PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2014
Last Update Date: 03/17/2023
Certification Date: 03/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 LLEWELLYN AVE
FORT MEADE MD
20755-7081
US

IV. Provider business mailing address

2480 LLEWELLYN AVE
FORT MEADE MD
20755-7081
US

V. Phone/Fax

Practice location:
  • Phone: 301-677-8192
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21764
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number21764
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: