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General NPI Number Information
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NPI Number | 1366196404
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Entity Type | Individual
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Provider Name | AARON MARCUS RAINES
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Gender | Male
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Dates
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Enumeration Date | 02/08/2022
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Last Update Date | 02/08/2022
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Provider Practice Location Address
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Address Line | 739 PARK ST
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City | CUMBERLAND
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State | MD
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Zip | 21502-3172
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Country | US
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Telephone | 301-777-7670
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Fax |
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Provider Business Mailing Address
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Address Line | 909 EASTGATE CT
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City | CUMBERLAND
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State | MD
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Zip | 21502-1811
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Country | US
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Telephone | 301-876-1996
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP0010901
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 25886
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License Number State | MD
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