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General NPI Number Information
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NPI Number | 1134154636
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Entity Type | Organization
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Legal Business Name | DENTON PHARMACY LLC
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 11/20/2013
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Provider Practice Location Address
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Address Line | 7 WEST BELLE ST
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City | RIDGELY
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State | MD
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Zip | 21660
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Country | US
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Telephone | 410-634-9800
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Fax | 410-634-9008
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Provider Business Mailing Address
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Address Line | 7 WEST BELLE ST
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City | RIDGELY
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State | MD
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Zip | 21660
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Country | US
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Telephone | 410-634-9800
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Fax | 410-634-9008
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Authorized Official
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Title or Position | OWNER
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Name | MRS. BRENDA L WALLS
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Credential |
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Telephone | 410-479-1100
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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 | P04033
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License Number State | MD
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