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General NPI Number Information
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NPI Number | 1811207079
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Entity Type | Organization
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Legal Business Name | UNION MEMORIAL HOSPITAL-PHARMACY DEPT
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Dates
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Enumeration Date | 10/20/2010
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 201 EAST UNIVERSITY PARKWAY PHARMACY DEPARTMENT
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City | BALTIMORE
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State | MD
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Zip | 21218-2895
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Country | US
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Telephone | 410-554-2555
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Fax | 410-554-2230
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Provider Business Mailing Address
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Address Line | 201 EAST UNIVERSITY PARKWAY PHARMACY DEPARTMENT
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City | BALTIMORE
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State | MD
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Zip | 21218-2895
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Country | US
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Telephone | 410-554-2555
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Fax | 410-554-2230
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | DR. LIESER MAYO
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Credential | PH.D.
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Telephone | 410-554-2907
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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 | P00797
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License Number State | MD
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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 | P00797
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License Number State | MD
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