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General NPI Number Information
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NPI Number | 1437256369
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Entity Type | Organization
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Legal Business Name | EASTERN SHORE PHARMACY INC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/02/2014
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Provider Practice Location Address
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Address Line | 400 EASTERN SHORE DR STE 103
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City | SALISBURY
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State | MD
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Zip | 21804-5513
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Country | US
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Telephone | 410-749-5253
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Fax | 410-749-6345
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Provider Business Mailing Address
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Address Line | 400 EASTERN SHORE DR STE 103
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City | SALISBURY
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State | MD
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Zip | 21804-5513
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Country | US
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Telephone | 410-749-5253
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Fax | 410-749-6345
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Authorized Official
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Title or Position | OWNER AND PHARMACIST
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Name | W ROBERT ELLIOTT
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Credential |
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Telephone | 410-749-5253
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P02267
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License Number State | MD
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