Healthcare Provider Details

I. General information

NPI: 1841332202
Provider Name (Legal Business Name): GREENSBORO PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 S MAIN ST
GREENSBORO MD
21639-0490
US

IV. Provider business mailing address

102 S MAIN ST PO BOX 490
GREENSBORO MD
21639-0490
US

V. Phone/Fax

Practice location:
  • Phone: 410-482-6256
  • Fax: 410-482-2469
Mailing address:
  • Phone: 410-482-6256
  • Fax: 410-482-2469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP00353
License Number StateMD

VIII. Authorized Official

Name: MRS. MICHELE TERESA CLOUGH
Title or Position: OWNER
Credential: RPH
Phone: 410-482-6256