Provider Demographics
NPI:1558571133
Name:SLAMOVITZ, LARRY B (RPH)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:B
Last Name:SLAMOVITZ
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 1:2611 THOMAS RUN RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-1218
Mailing Address - Country:US
Mailing Address - Phone:410-879-5577
Mailing Address - Fax:410-620-1296
Practice Address - Street 1:723 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5309
Practice Address - Country:US
Practice Address - Phone:410-398-4383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08412183500000X
FLPS32171183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist