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NPI Code Detail

MEDICARE: PENN NORTH FOOT CARE

MEDICARE: PENN NORTH FOOT CARE
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
1333600000XPharmacy01235MD
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12132532OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1497797922
Entity Type Code : Organization
Provider Name (Legal Business Name) : PENN NORTH FOOT CARE
Provider Business Mailing Address
First Line : 2412-14 PENNSYLVANIA AVENUE
Second Line :
City : BALTIMORE
State : MD
Zip : 21217
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2412-14 PENNSYLVANIA AVENUE
Second Line :
City : BALTIMORE
State : MD
Zip : 21217
Country : US
Telephone Number : 410-523-5700
Fax Number : 410-523-5733
Authorized Official
Title or Position : PRESIDENT
Name : STEVEN BENNETT
Credential :
Telephone Number : 443-326-1908
Provider Enumeration Date : 06/11/2006
Last Update Date : 09/11/2025

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Directions to “PENN NORTH FOOT CARE ” Practice Location

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