Provider Demographics
NPI:1518382290
Name:MARYLAND PHARMACY AND HOME INFUSION INC.
Entity Type:Organization
Organization Name:MARYLAND PHARMACY AND HOME INFUSION INC.
Other - Org Name:ZONETAK PHARMACY 4
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER OF PHARMACY OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:BUAGU
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSAZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-824-4821
Mailing Address - Street 1:1251 WEST PRATT STREET
Mailing Address - Street 2:UNIT 10
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21223
Mailing Address - Country:US
Mailing Address - Phone:410-962-7013
Mailing Address - Fax:410-962-7014
Practice Address - Street 1:2300 GARRISON BLVD
Practice Address - Street 2:STE 200
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21216-2335
Practice Address - Country:US
Practice Address - Phone:443-449-7431
Practice Address - Fax:443-449-7436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-04
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP06167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty