Healthcare Provider Details

I. General information

NPI: 1891276150
Provider Name (Legal Business Name): ADRIENNE KOWCZ PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2018
Last Update Date: 08/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 ELKRIDGE LANDING RD
LINTHICUM MD
21090-2917
US

IV. Provider business mailing address

920 ELKRIDGE LANDING RD
LINTHICUM MD
21090-2917
US

V. Phone/Fax

Practice location:
  • Phone: 203-615-3524
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number22455
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: