Provider Demographics
NPI:1235427048
Name:MOODY, ASHLEY ELAINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:ELAINE
Last Name:MOODY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ASHLEY
Other - Middle Name:ELAINE
Other - Last Name:MCCABE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4701 N CHARLES ST
Mailing Address - Street 2:BUNTING HALL 132
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-2404
Mailing Address - Country:US
Mailing Address - Phone:410-532-5073
Mailing Address - Fax:
Practice Address - Street 1:4701 N CHARLES ST
Practice Address - Street 2:BUNTING HALL 132
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2404
Practice Address - Country:US
Practice Address - Phone:410-532-5073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist