MEDICARE: SEQUON INC

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	333600000X	Pharmacy	PO4164	MD
2	3336C0003X	Community/Retail Pharmacy
3	3336L0003X	Long Term Care Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2132188	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1487680104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEQUON INC

Provider Business Mailing Address
First Line	:	PO BOX 453
Second Line	:
City	:	STEVENSON
State	:	MD
Zip	:	21153-0453
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1595 OPOSSUMTOWN PIKE
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-4673
Country	:	US
Telephone Number	:	301-624-4008
Fax Number	:	301-624-4009

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOEL FELDMAN
Credential	:
Telephone Number	:	410-292-3730

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	09/11/2025

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Directions to “SEQUON INC ” Practice Location

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