Provider Demographics
NPI:1457625105
Name:CUNNINGHAM, PATRICK L (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:L
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-1211
Mailing Address - Country:US
Mailing Address - Phone:301-724-9212
Mailing Address - Fax:
Practice Address - Street 1:10601 NEW GEORGES CREEK RD SW
Practice Address - Street 2:
Practice Address - City:FROSTBURG
Practice Address - State:MD
Practice Address - Zip Code:21532-1453
Practice Address - Country:US
Practice Address - Phone:301-689-9961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD8570183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist