MEDICARE: AYZA LLC

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	3336C0003X	Community/Retail Pharmacy	P04737	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2033691	OTHER		PK

General Provider Information

NPI Number	:	1912055575
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AYZA LLC

Provider Business Mailing Address
First Line	:	PO BOX 256
Second Line	:
City	:	WOODBINE
State	:	MD
Zip	:	21797-0256
Country	:	US
Telephone Number	:	410-549-1900
Fax Number	:	410-549-3776

Provider Business Practice Location Address
First Line	:	7627 WOODBINE RD
Second Line	:
City	:	WOODBINE
State	:	MD
Zip	:	21797-8939
Country	:	US
Telephone Number	:	410-549-1900
Fax Number	:	410-549-3776

Authorized Official
Title or Position	:	OWNER
Name	:	ZUBAIR AZAM
Credential	:
Telephone Number	:	410-549-1900

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	06/06/2016

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Directions to “AYZA LLC ” Practice Location

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