MEDICARE: MR. SANTOSH KUMAR DWARAKANATH 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	17514	MD

General Provider Information

NPI Number	:	1104859537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SANTOSH KUMAR DWARAKANATH RPH

Provider Business Mailing Address
First Line	:	6911 OLD WATERLOO RD
Second Line	:
City	:	ELKRIDGE
State	:	MD
Zip	:	21075-6529
Country	:	US
Telephone Number	:	443-992-4720
Fax Number	:	866-778-6726

Provider Business Practice Location Address
First Line	:	700 WASHINGTON BLVD
Second Line	:	PHARMERICA
City	:	BALTIMORE
State	:	MD
Zip	:	21230-2350
Country	:	US
Telephone Number	:	410-539-4986
Fax Number	:

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

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	11/02/2007

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