Provider Demographics
NPI:1023581279
Name:MORRELL PARK PHARMACY
Entity type:Organization
Organization Name:MORRELL PARK PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MORRELL PARK
Authorized Official - Middle Name:
Authorized Official - Last Name:PHARMACY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-401-5312
Mailing Address - Street 1:2519 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-1406
Mailing Address - Country:US
Mailing Address - Phone:410-401-5312
Mailing Address - Fax:410-401-5306
Practice Address - Street 1:2519 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-1406
Practice Address - Country:US
Practice Address - Phone:410-401-5312
Practice Address - Fax:410-401-5306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-09
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy