MEDICARE: MARIAH MIRELES

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	183700000X	Pharmacy Technician	T27131	MD

General Provider Information

NPI Number	:	1841981735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIAH MIRELES

Provider Business Mailing Address
First Line	:	6402 GOLDEN RING RD
Second Line	:
City	:	ROSEDALE
State	:	MD
Zip	:	21237-2010
Country	:	US
Telephone Number	:	410-866-2500
Fax Number	:	410-866-2500

Provider Business Practice Location Address
First Line	:	6402 GOLDEN RING RD
Second Line	:
City	:	ROSEDALE
State	:	MD
Zip	:	21237-2010
Country	:	US
Telephone Number	:	410-866-2500
Fax Number	:	410-866-6486

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

Provider Enumeration Date	:	05/19/2023
Last Update Date	:	05/19/2023

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Directions to “ MARIAH MIRELES ” Practice Location

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