Provider Demographics
NPI:1932509247
Name:BOSCO, LINDA WALTER (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:WALTER
Last Name:BOSCO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 HUNGERFORD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4167
Mailing Address - Country:US
Mailing Address - Phone:301-279-9144
Mailing Address - Fax:301-610-6613
Practice Address - Street 1:360 HUNGERFORD DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4167
Practice Address - Country:US
Practice Address - Phone:301-279-9144
Practice Address - Fax:301-610-6613
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07773183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist