Provider Demographics
NPI:1891780169
Name:GOSE, JUNE MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JUNE
Middle Name:MARIE
Last Name:GOSE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7010 LENNOX AVE
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6314
Mailing Address - Country:US
Mailing Address - Phone:410-796-5643
Mailing Address - Fax:
Practice Address - Street 1:8186 LARK BROWN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6420
Practice Address - Country:US
Practice Address - Phone:443-620-9990
Practice Address - Fax:443-620-9993
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15149183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist