MEDICARE: ELLIOT FREED

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	13126	MD

General Provider Information

NPI Number	:	1457760050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLIOT FREED

Provider Business Mailing Address
First Line	:	6828 REISTERSTOWN RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-1428
Country	:	US
Telephone Number	:	410-764-3445
Fax Number	:	410-585-0122

Provider Business Practice Location Address
First Line	:	6828 REISTERSTOWN RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-1428
Country	:	US
Telephone Number	:	410-764-3445
Fax Number	:	410-585-0122

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

Provider Enumeration Date	:	08/07/2014
Last Update Date	:	08/07/2014

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Directions to “ ELLIOT FREED ” Practice Location

Language	Start Address	Practice Location

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