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General NPI Number Information
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NPI Number | 1952514580
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Entity Type | Organization
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Legal Business Name | VETCENTRIC INC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 451 DEFENSE HIGHWAY SUITE C
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City | ANNAPOLIS
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State | MD
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Zip | 21401
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Country | US
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Telephone | 410-266-8818
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Fax | 410-266-6483
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Provider Business Mailing Address
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Address Line | 451 DEFENSE HIGHWAY SUITE C
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City | ANNAPOLIS
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State | MD
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Zip | 21401
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Country | US
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Telephone | 410-266-8818
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Fax | 410-266-6483
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Authorized Official
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Title or Position | ACTING DIRECTOR PHARMACY
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Name | DR. JACOB R RAITT
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Credential | PHD RPH
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Telephone | 410-266-8818
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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 | PW0229
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License Number State | MD
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