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General NPI Number Information
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NPI Number | 1962889568
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Entity Type | Organization
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Legal Business Name | NORTH EAST PHARMACY INC
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Dates
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Enumeration Date | 05/03/2015
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Last Update Date | 06/25/2015
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Provider Practice Location Address
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Address Line | 2316 PULASKI HWY STE A
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City | NORTH EAST
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State | MD
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Zip | 21901-3730
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Country | US
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Telephone | 443-674-8226
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Fax | 443-674-8346
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Provider Business Mailing Address
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Address Line | 2316 PULASKI HWY SUITE A
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City | NORTH EAST
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State | MD
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Zip | 21901-3730
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Country | US
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Telephone | 443-674-8226
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Fax | 443-674-8346
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | SATISH MUSKU
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Credential |
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Telephone | 443-674-8226
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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 | P06861
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License Number State | MD
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