Provider Demographics
NPI:1487924858
Name:CHI, RUTH (PHARMD)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:CHI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7602 RESERVE CIR
Mailing Address - Street 2:APT 103
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-1610
Mailing Address - Country:US
Mailing Address - Phone:612-735-4258
Mailing Address - Fax:
Practice Address - Street 1:3301 N RIDGE RD
Practice Address - Street 2:#4
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-7500
Practice Address - Country:US
Practice Address - Phone:410-480-3817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20356183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist