Provider Demographics
NPI:1992024624
Name:BLOCK, HAROLD JACK (RPH)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:JACK
Last Name:BLOCK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 REISTERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3806
Mailing Address - Country:US
Mailing Address - Phone:410-602-1404
Mailing Address - Fax:410-602-1408
Practice Address - Street 1:1404 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-3806
Practice Address - Country:US
Practice Address - Phone:410-602-1404
Practice Address - Fax:410-602-1408
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07148183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist