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General NPI Number Information
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NPI Number | 1598036618
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Entity Type | Organization
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Legal Business Name | CHASE BREXTON
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Dates
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Enumeration Date | 01/20/2012
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 5500 KNOLL NORTH DR STE 370
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City | COLUMBIA
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State | MD
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Zip | 21045-2393
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Country | US
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Telephone | 410-837-2050
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Fax | 443-573-5010
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Provider Business Mailing Address
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Address Line | 1111 N CHARLES ST
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City | BALTIMORE
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State | MD
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Zip | 21201-5505
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Country | US
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Telephone | 410-837-2050
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Fax | 443-573-5010
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | JEFFREY CYWINSKI
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Credential | RPH
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Telephone | 410-837-2050
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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 | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | P05715
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License Number State | MD
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