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General NPI Number Information
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NPI Number | 1417832577
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Entity Type | Organization
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Legal Business Name | SEQUON, LLC
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 601 CHINQUAPIN ROUND RD
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City | ANNAPOLIS
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State | MD
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Zip | 21401-4009
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Country | US
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Telephone | 443-837-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 40 WIGHT AVE STE 100
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City | COCKEYSVILLE
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State | MD
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Zip | 21030-2148
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Country | US
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Telephone | 667-408-7767
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | DANIEL MANDOLI
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Credential |
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Telephone | 667-408-7767
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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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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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