Healthcare Provider Details

I. General information

NPI: 1063535292
Provider Name (Legal Business Name): SHARON LYNN GELMINI SHRADER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 11/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 W 7TH ST
FREDERICK MD
21702-4102
US

IV. Provider business mailing address

1305 W 7TH ST
FREDERICK MD
21702-4102
US

V. Phone/Fax

Practice location:
  • Phone: 301-662-5888
  • Fax:
Mailing address:
  • Phone: 301-662-5888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13135
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: