Provider Demographics
NPI:1083938427
Name:SARG, MOHAMED TAHA (RPH)
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:TAHA
Last Name:SARG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 S GREENE ST
Mailing Address - Street 2:CENTRAL PHARMACY
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1544
Mailing Address - Country:US
Mailing Address - Phone:410-328-5644
Mailing Address - Fax:410-328-8474
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:CENTRAL PHARMACY
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-5644
Practice Address - Fax:410-328-8474
Is Sole Proprietor?:No
Enumeration Date:2010-03-14
Last Update Date:2010-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18903183500000X
PARP443486183500000X
MI5302037493183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist