MEDICARE: FELDMAN'S MEDICAL CENTER PHARMACY, 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	P01534	MD

General Provider Information

NPI Number	:	1891770632
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FELDMAN'S MEDICAL CENTER PHARMACY, INC.

Provider Business Mailing Address
First Line	:	9501 OLD ANNAPOLIS RD
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-6314
Country	:	US
Telephone Number	:	410-730-8200
Fax Number	:	410-730-8092

Provider Business Practice Location Address
First Line	:	9501 OLD ANNAPOLIS RD
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-6314
Country	:	US
Telephone Number	:	410-730-8200
Fax Number	:	410-730-8092

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. LESLIE S. FELDMAN
Credential	:	RPH
Telephone Number	:	410-730-8200

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	08/22/2020

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