Healthcare Provider Details

I. General information

NPI: 1114238011
Provider Name (Legal Business Name): ERIN ELWOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2010
Last Update Date: 06/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 WATER ST
THURMONT MD
21788-1912
US

IV. Provider business mailing address

9664 ATTERBURY LANE
FREDERICK MD
21704
US

V. Phone/Fax

Practice location:
  • Phone: 301-271-2223
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19227
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: