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General NPI Number Information
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NPI Number | 1104049311
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Entity Type | Organization
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Legal Business Name | COLUMBIA MED SERVICES
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 9693 GERWIG LN STE R
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City | COLUMBIA
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State | MD
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Zip | 21046-2837
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Country | US
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Telephone | 410-290-6599
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Fax | 410-290-8874
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Provider Business Mailing Address
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Address Line | 9693 GERWIG LN STE R
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City | COLUMBIA
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State | MD
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Zip | 21046-2837
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Country | US
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Telephone | 410-290-6599
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Fax | 410-290-8874
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Authorized Official
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Title or Position | CEO
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Name | BRENDA MARSHALL
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Credential |
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Telephone | 410-290-6599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PW0263
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License Number State | MD
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