Healthcare Provider Details

I. General information

NPI: 1386567253
Provider Name (Legal Business Name): MARY KATHRYN GOODELL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEMORIAL AVE
WESTMINSTER MD
21157-5726
US

IV. Provider business mailing address

3 DODWORTH CT APT 304
LUTHERVILLE TIMONIUM MD
21093-2014
US

V. Phone/Fax

Practice location:
  • Phone: 410-848-3000
  • Fax:
Mailing address:
  • Phone: 443-804-3588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number25843
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: