Healthcare Provider Details

I. General information

NPI: 1922144534
Provider Name (Legal Business Name): MT CARMEL MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 02/14/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MOUNT CARMEL RD
PARKTON MD
21120-9706
US

IV. Provider business mailing address

PO BOX 553
MONKTON MD
21111-0553
US

V. Phone/Fax

Practice location:
  • Phone: 410-343-0110
  • Fax: 410-343-1578
Mailing address:
  • Phone: 410-343-0110
  • Fax: 410-343-1578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP01303
License Number StateMD

VIII. Authorized Official

Name: DR. DENNIS EATON JR.
Title or Position: OWNER-PHARMACIST
Credential: PHARMD
Phone: 410-357-8200