Provider Demographics
NPI:1255474227
Name:CIANEL HEALTH SPECIFICS
Entity Type:Organization
Organization Name:CIANEL HEALTH SPECIFICS
Other - Org Name:CIANEL PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:LAUR
Authorized Official - Middle Name:N
Authorized Official - Last Name:ONYEKWERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-869-0099
Mailing Address - Street 1:4 W ROLLING CROSSROADS
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-6280
Mailing Address - Country:US
Mailing Address - Phone:410-869-0099
Mailing Address - Fax:410-869-9740
Practice Address - Street 1:4 W ROLLING CROSSROADS
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-6280
Practice Address - Country:US
Practice Address - Phone:410-869-0099
Practice Address - Fax:410-869-9740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11285183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5415610001Medicare ID - Type UnspecifiedPHARMACY