Healthcare Provider Details

I. General information

NPI: 1831324698
Provider Name (Legal Business Name): RAELENE W SKERDA RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2009
Last Update Date: 05/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 FISHERS LN PARKLAWN, ROOM 12A12
ROCKVILLE MD
20852-1750
US

IV. Provider business mailing address

5600 FISHERS LN PARKLAWN, ROOM 12A12
ROCKVILLE MD
20852-1750
US

V. Phone/Fax

Practice location:
  • Phone: 301-443-5277
  • Fax: 301-443-2870
Mailing address:
  • Phone: 301-443-5277
  • Fax: 301-443-2870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP030871L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: