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General NPI Number Information
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NPI Number | 1386461309
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Entity Type | Individual
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Provider Name | OBED NIMOH CPHT
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Gender | Male
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Dates
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Enumeration Date | 09/21/2024
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Last Update Date | 09/21/2024
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Provider Practice Location Address
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Address Line | 400 W 7TH ST
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City | FREDERICK
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State | MD
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Zip | 21701-4593
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Country | US
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Telephone | 240-566-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 341C FIELDPOINTE BLVD APT 102
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City | FREDERICK
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State | MD
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Zip | 21701-1217
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Country | US
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Telephone | 240-614-1259
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | T15713
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License Number State | MD
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