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General NPI Number Information
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NPI Number | 1194927996
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Entity Type | Organization
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Legal Business Name | FELLS POINT PHARMACY INC.
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1704 FLEET ST
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City | BALTIMORE
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State | MD
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Zip | 21231-2916
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Country | US
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Telephone | 443-320-0704
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Fax |
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Provider Business Mailing Address
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Address Line | 1704 FLEET ST
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City | BALTIMORE
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State | MD
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Zip | 21231-2916
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Country | US
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Telephone | 443-320-0704
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Fax |
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | MRS. OLAIDE AJEIGBE
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Credential | RPH
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Telephone | 240-398-9172
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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 | P04559
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License Number State | MD
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