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General NPI Number Information
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NPI Number | 1124285754
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Entity Type | Organization
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Legal Business Name | JOHNS HOPKINS OP PHCY AT ELDER PLUS
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 05/21/2008
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Provider Practice Location Address
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Address Line | 4940 EASTERN AVE RMHE 137 MASON F LORD BLDG E TWR
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City | BALTIMORE
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State | MD
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Zip | 21224-2735
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Country | US
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Telephone | 410-550-5354
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Fax | 410-550-7864
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Provider Business Mailing Address
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Address Line | PO BOX 630646
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City | BALTIMORE
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State | MD
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Zip | 21263-0646
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OP PHCY
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Name | NATHAN THOMPSON
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Credential | RPH MBA
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Telephone | 410-288-8022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P04438
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License Number State | MD
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