Provider Demographics
NPI:1871837419
Name:NORTHERN PHARMACY AND MEDICAL EQUIPMENT, INC
Entity Type:Organization
Organization Name:NORTHERN PHARMACY AND MEDICAL EQUIPMENT, INC
Other - Org Name:AMENDRX @ NORTHERN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PEPPER
Authorized Official - Middle Name:KAREN
Authorized Official - Last Name:MINTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-254-2055
Mailing Address - Street 1:6701 HARFORD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-7707
Mailing Address - Country:US
Mailing Address - Phone:443-909-7899
Mailing Address - Fax:443-321-0542
Practice Address - Street 1:6701 HARFORD RD
Practice Address - Street 2:SUITE B
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-7707
Practice Address - Country:US
Practice Address - Phone:443-909-7899
Practice Address - Fax:443-321-0542
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHERN PHARMACY AND MEDICAL EQUIPMENT, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-20
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDPW03633336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy