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General NPI Number Information
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NPI Number | 1649580671
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF MARYLAND MEDICAL SYSTEMS-CORPORATION
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Dates
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Enumeration Date | 10/08/2010
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Last Update Date | 11/20/2012
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Provider Practice Location Address
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Address Line | 621 S CHARLES ST
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City | BALTIMORE
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State | MD
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Zip | 21230-3801
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Country | US
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Telephone | 443-682-6570
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Fax |
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Provider Business Mailing Address
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Address Line | 29 S GREENE ST SUITE 400
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City | BALTIMORE
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State | MD
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Zip | 21201-1504
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Country | US
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Telephone | 410-328-1308
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Fax |
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Authorized Official
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Title or Position | BUSINESS OPERATIONS MANAGER
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Name | BRET ELAM
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Credential |
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Telephone | 410-328-7745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P05395
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License Number State | MD
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