Provider Demographics
NPI:1003227729
Name:ATLANTIC GENERAL HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:ATLANTIC GENERAL HOSPITAL CORPORATION
Other - Org Name:AGH REDISCRIPTS PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MCGINNIS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:410-641-9727
Mailing Address - Street 1:9733 HEALTHWAY DR
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811-1155
Mailing Address - Country:US
Mailing Address - Phone:410-641-9727
Mailing Address - Fax:410-641-9750
Practice Address - Street 1:9733 HEALTHWAY DR
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-1155
Practice Address - Country:US
Practice Address - Phone:410-641-9727
Practice Address - Fax:410-641-9750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-15
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP06310333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy