MEDICARE: CHESAPEAKE DRUG 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
2	3336C0003X	Community/Retail Pharmacy	P00055	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2033435	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669418026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHESAPEAKE DRUG INC

Provider Business Mailing Address
First Line	:	15 E CHESAPEAKE BEACH RD
Second Line	:	#160
City	:	OWINGS
State	:	MD
Zip	:	20736-3517
Country	:	US
Telephone Number	:	410-257-3700
Fax Number	:	410-257-0540

Provider Business Practice Location Address
First Line	:	15 E CHESAPEAKE BEACH RD
Second Line	:	#160
City	:	OWINGS
State	:	MD
Zip	:	20736-3517
Country	:	US
Telephone Number	:	410-257-3700
Fax Number	:	410-257-0540

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LEO MALLARD
Credential	:	RPH
Telephone Number	:	410-741-5150

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	03/16/2017

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Directions to “CHESAPEAKE DRUG INC ” Practice Location

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