Healthcare Provider Details

I. General information

NPI: 1225975683
Provider Name (Legal Business Name): KELSEY TAYLOR COUNCIL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21400 ZEEMAN RD
ROCK HALL MD
21661-1515
US

IV. Provider business mailing address

21400 ZEEMAN RD
ROCK HALL MD
21661-1515
US

V. Phone/Fax

Practice location:
  • Phone: 410-639-9140
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number30877
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: