Provider Demographics
NPI:1851763312
Name:STORM, ALAN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:STORM
Suffix:
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 1:5619 COLUMBIA RD APT 302
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-2082
Mailing Address - Country:US
Mailing Address - Phone:304-281-3635
Mailing Address - Fax:
Practice Address - Street 1:5619 COLUMBIA RD APT 302
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2082
Practice Address - Country:US
Practice Address - Phone:304-281-3635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-23
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21730183500000X
WVRP0008096183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist