MEDICARE: MAUREEN MOONEY RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	10185	MD

General Provider Information

NPI Number	:	1093062291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN MOONEY RPH

Provider Business Mailing Address
First Line	:	3433 LAUREL FORT MEADE RD
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20724-2003
Country	:	US
Telephone Number	:	301-483-0949
Fax Number	:

Provider Business Practice Location Address
First Line	:	3433 LAUREL FORT MEADE RD
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20724-2003
Country	:	US
Telephone Number	:	301-483-0949
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2012
Last Update Date	:	08/07/2012

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