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NPI Code Detail

MEDICARE: DICKSON C NWOSU RPH

MEDICARE:   DICKSON C NWOSU  RPH
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
1183500000XPharmacist12238MD

General Provider Information

NPI Number : 1932418241
Entity Type Code : Individual
Provider Name (Legal Business Name) : DICKSON C NWOSU RPH
Provider Business Mailing Address
First Line : 7808 KEENAN RD
Second Line :
City : GLEN BURNIE
State : MD
Zip : 21061-4854
Country : US
Telephone Number : 410-760-2172
Fax Number : 410-760-2172
Provider Business Practice Location Address
First Line : 92 SOUDER RD
Second Line :
City : BRUNSWICK
State : MD
Zip : 21716-1245
Country : US
Telephone Number : 301-834-8100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2010
Last Update Date : 10/04/2010

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Directions to “ DICKSON C NWOSU RPH” Practice Location

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