Healthcare Provider Details

I. General information

NPI: 1598106908
Provider Name (Legal Business Name): JENNIFER LAUREY DENNIS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2013
Last Update Date: 07/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9616 HARFORD RD
PARKVILLE MD
21234-2104
US

IV. Provider business mailing address

7165 COLUMBIA GATEWAY DR
COLUMBIA MD
21046-2539
US

V. Phone/Fax

Practice location:
  • Phone: 410-663-7957
  • Fax: 410-663-6953
Mailing address:
  • Phone: 410-290-1054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21641
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: