Provider Demographics
NPI:1649580671
Name:UNIVERSITY OF MARYLAND MEDICAL SYSTEMS-CORPORATION
Entity Type:Organization
Organization Name:UNIVERSITY OF MARYLAND MEDICAL SYSTEMS-CORPORATION
Other - Org Name:UMMS PHARMACY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRET
Authorized Official - Middle Name:
Authorized Official - Last Name:ELAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-328-7745
Mailing Address - Street 1:29 S GREENE ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1504
Mailing Address - Country:US
Mailing Address - Phone:410-328-1308
Mailing Address - Fax:
Practice Address - Street 1:621 S CHARLES ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-3801
Practice Address - Country:US
Practice Address - Phone:443-682-6570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP053953336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2135463OtherNCPDP PROVIDER IDENTIFICATION NUMBER