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General NPI Number Information
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NPI Number | 1285994814
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Entity Type | Organization
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Legal Business Name | SRI GANESH PHARMACY OF CUMBERLAND INC
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Dates
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Enumeration Date | 05/16/2012
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Last Update Date | 03/16/2015
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Provider Practice Location Address
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Address Line | 501 N CENTRE ST
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City | CUMBERLAND
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State | MD
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Zip | 21502-2102
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Country | US
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Telephone | 301-722-2342
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Fax | 301-722-3611
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Provider Business Mailing Address
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Address Line | 501 N CENTRE ST
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City | CUMBERLAND
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State | MD
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Zip | 21502-2102
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Country | US
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Telephone | 301-722-2342
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Fax | 301-722-3611
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | TEJAS SHETH
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Credential |
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Telephone | 301-722-2342
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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 | P05718
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License Number State | MD
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