Provider Demographics
NPI:1982099107
Name:COLUMBIA TOWN CENTER PHARMACY
Entity Type:Organization
Organization Name:COLUMBIA TOWN CENTER PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMEBET
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEMAYEHU
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:443-546-4189
Mailing Address - Street 1:5550 STERRETT PL STE 103
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-2625
Mailing Address - Country:US
Mailing Address - Phone:443-546-4189
Mailing Address - Fax:
Practice Address - Street 1:5550 STERRETT PL STE 103
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2625
Practice Address - Country:US
Practice Address - Phone:443-546-4189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP06676333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy