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General NPI Number Information
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NPI Number | 1356637243
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Entity Type | Individual
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Provider Name | KEVIN J GORSLINE PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 06/20/2011
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Last Update Date | 06/20/2011
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Provider Practice Location Address
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Address Line | 10456 BALTIMORE AVE
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City | BELTSVILLE
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State | MD
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Zip | 20705-2321
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Country | US
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Telephone | 301-937-1624
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 WASHINGTON BLVD APT. 209
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City | ARLINGTON
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State | VA
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Zip | 22201-2159
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Country | US
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Telephone | 607-206-3615
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 0202210282
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | RP444680
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License Number State | PA
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