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General NPI Number Information
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NPI Number | 1316567977
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Entity Type | Organization
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Legal Business Name | JANT PHARMACY LLC
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Dates
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Enumeration Date | 04/23/2020
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Last Update Date | 01/13/2021
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Provider Practice Location Address
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Address Line | 8771 PINEY ORCHARD PKWY
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City | ODENTON
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State | MD
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Zip | 21113-2245
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Country | US
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Telephone | 301-523-7087
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Fax |
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Provider Business Mailing Address
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Address Line | 8771 PINEY ORCHARD PKWY
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City | ODENTON
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State | MD
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Zip | 21113-2245
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Country | US
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Telephone | 301-523-7087
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. KOFI JANTUAH
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Credential | PHARMD
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Telephone | 301-523-7087
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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 |
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License Number State |
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