=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952347429
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RONALD GERSTELL SHOWACRE R.PH.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/21/2006
-----------------------------------------------------
Last Update Date | 09/12/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2002 MEDICAL PKWY SUITE 170
-----------------------------------------------------
City | ANNAPOLIS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21401-3046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-573-6900
-----------------------------------------------------
Fax | 410-573-1127
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2002 MEDICAL PKWY SUITE 170
-----------------------------------------------------
City | ANNAPOLIS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21401-3046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-573-6900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 9642
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------