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General NPI Number Information
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NPI Number | 1295819837
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Entity Type | Organization
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Legal Business Name | ABOVE (B2)
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 10/25/2012
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Provider Practice Location Address
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Address Line | 8125 H RITCHIE HIGHWAY
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City | PASADENA
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State | MD
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Zip | 21122-6925
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Country | US
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Telephone | 410-224-6483
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Fax | 410-224-6404
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Provider Business Mailing Address
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Address Line | PO BOX 6725
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City | ANNAPOLIS
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State | MD
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Zip | 21401-0725
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Country | US
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Telephone | 443-332-4260
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Fax | 410-269-0510
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Authorized Official
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Title or Position | CHIEF OPERATING OPERATOR
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Name | KIMBERLY A. BRESNAHAN
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Credential |
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Telephone | 443-332-4260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | D0013889
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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