Provider Demographics
NPI:1134404627
Name:DEMIRKAN, COLLEEN L (PHARMD)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:L
Last Name:DEMIRKAN
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 1:1460 RITCHIE HWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-2730
Mailing Address - Country:US
Mailing Address - Phone:443-949-8373
Mailing Address - Fax:443-949-8375
Practice Address - Street 1:1460 RITCHIE HWY
Practice Address - Street 2:SUITE 103
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-2730
Practice Address - Country:US
Practice Address - Phone:443-949-8373
Practice Address - Fax:443-949-8375
Is Sole Proprietor?:No
Enumeration Date:2011-10-15
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20312183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist