Provider Demographics
NPI:1275818239
Name:TOSH, NORMAN LANE (RPH)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:LANE
Last Name:TOSH
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 1:2556 W PULASKI HWY
Mailing Address - Street 2:
Mailing Address - City:NORTHJ EAST
Mailing Address - State:MD
Mailing Address - Zip Code:21901
Mailing Address - Country:US
Mailing Address - Phone:410-287-8887
Mailing Address - Fax:410-287-7304
Practice Address - Street 1:2556 W PULASKI HWY
Practice Address - Street 2:
Practice Address - City:NORTHJ EAST
Practice Address - State:MD
Practice Address - Zip Code:21901
Practice Address - Country:US
Practice Address - Phone:410-287-8887
Practice Address - Fax:410-287-7304
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10087183500000X
DEA1-0002747183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist