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General NPI Number Information
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NPI Number | 1518235993
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Entity Type | Organization
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Legal Business Name | MCCREADY FOUNDATION, INC
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Dates
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Enumeration Date | 12/13/2011
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Last Update Date | 12/13/2011
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Provider Practice Location Address
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Address Line | 201 HALL HWY
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City | CRISFIELD
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State | MD
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Zip | 21817-1237
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Country | US
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Telephone | 410-968-1200
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Fax | 410-968-1023
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Provider Business Mailing Address
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Address Line | 201 HALL HWY
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City | CRISFIELD
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State | MD
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Zip | 21817-1237
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Country | US
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Telephone | 410-968-1200
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Fax | 410-968-1023
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | DR. FRANK GOLDMAN
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Credential | PHARMD
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Telephone | 410-968-1200
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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 | PO2589
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License Number State | MD
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