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General NPI Number Information
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NPI Number | 1982099107
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Entity Type | Organization
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Legal Business Name | COLUMBIA TOWN CENTER PHARMACY
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Dates
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Enumeration Date | 04/03/2015
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Last Update Date | 04/03/2015
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Provider Practice Location Address
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Address Line | 5550 STERRETT PL STE 103
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City | COLUMBIA
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State | MD
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Zip | 21044-2625
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Country | US
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Telephone | 443-546-4189
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Fax |
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Provider Business Mailing Address
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Address Line | 5550 STERRETT PL STE 103
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City | COLUMBIA
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State | MD
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Zip | 21044-2625
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Country | US
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Telephone | 443-546-4189
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MRS. EMEBET ALEMAYEHU
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Credential | RPH
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Telephone | 443-546-4189
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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 | P06676
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License Number State | MD
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