=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811319957
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BAYVIEW CENTER PHARMACY AND MEDICAL EQUIPMENT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2014
-----------------------------------------------------
Last Update Date | 01/08/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6510 ODONNELL ST
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21224-4643
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-633-6262
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6510 ODONNELL ST
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21224-4643
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-633-6262
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST
-----------------------------------------------------
Name | DR. MARIA GIANNAS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 410-633-6262
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | 0439
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------