Provider Demographics
NPI:1821309378
Name:CULLORS, ARLEN EDSEL JR (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ARLEN
Middle Name:EDSEL
Last Name:CULLORS
Suffix:JR
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2427 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-4039
Mailing Address - Country:US
Mailing Address - Phone:410-383-8506
Mailing Address - Fax:410-383-8506
Practice Address - Street 1:250 W CHASE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4815
Practice Address - Country:US
Practice Address - Phone:410-752-4473
Practice Address - Fax:410-752-6488
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15822183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD15822OtherMARYLAND PHARMACY BOARD