Provider Demographics
NPI:1922549583
Name:SANTELL, JOHN (RPH, MS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:SANTELL
Suffix:
Gender:M
Credentials:RPH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 LITTLE QUARRY RD
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-5680
Mailing Address - Country:US
Mailing Address - Phone:301-869-0517
Mailing Address - Fax:
Practice Address - Street 1:108 LITTLE QUARRY RD
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-5680
Practice Address - Country:US
Practice Address - Phone:301-869-0517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS24663183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist