Provider Demographics
NPI:1639703523
Name:EMADI, MARY KATHERINE (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHERINE
Last Name:EMADI
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 LONDONTOWN BLVD
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6409
Mailing Address - Country:US
Mailing Address - Phone:410-552-5749
Mailing Address - Fax:844-411-6763
Practice Address - Street 1:1320 LONDONTOWN BLVD
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6409
Practice Address - Country:US
Practice Address - Phone:410-552-5749
Practice Address - Fax:844-411-6763
Is Sole Proprietor?:No
Enumeration Date:2020-02-28
Last Update Date:2020-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD143761835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist