Provider Demographics
NPI:1366625279
Name:MEDBANK OF MARYLAND INC
Entity Type:Organization
Organization Name:MEDBANK OF MARYLAND INC
Other - Org Name:MEDBANK PHARMACY INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OPERATIONS MGR/ ASST. EXEC. DIR.
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:FORNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-821-9262
Mailing Address - Street 1:7400 YORK RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7531
Mailing Address - Country:US
Mailing Address - Phone:410-821-9262
Mailing Address - Fax:410-821-9265
Practice Address - Street 1:7400 YORK RD
Practice Address - Street 2:SUITE 400
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7531
Practice Address - Country:US
Practice Address - Phone:410-821-9262
Practice Address - Fax:410-821-9265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDPW02203336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy