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Individual
MARY E BOLTE
Active
Individual
MARY E BOLTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
12553
MD
183500000X
Pharmacist
Primary
RP037825L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12553
MARYLAND PHARMACY LICENSE
MD
01
—
RP037825L
PA PHARMACY LICENSE
PA
Enumeration date
10/25/2012
Last updated
10/25/2012
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