Provider Demographics
NPI:1922043694
Name:MBI AND MALERK INC
Entity Type:Organization
Organization Name:MBI AND MALERK INC
Other - Org Name:THE MEDICINE SHOPPE PHARMACY 1501
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:T
Authorized Official - Last Name:MBI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:410-730-9140
Mailing Address - Street 1:10451 TWIN RIVERS ROAD STE 105
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044
Mailing Address - Country:US
Mailing Address - Phone:410-730-9140
Mailing Address - Fax:410-730-9404
Practice Address - Street 1:10451 TWIN RIVERS ROAD STE 105
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044
Practice Address - Country:US
Practice Address - Phone:410-730-9140
Practice Address - Fax:410-730-9404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP02054333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD02054OtherSTATE LC
BT5408201OtherDEA
BT5408201OtherDEA