Organization
LLODNA INCORPORATED
Active
Other names
HARLEM GARDENS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE ANDOLL PHARMACIST (PHARMACIST)
(410) 523-5900
Entity
Organization
Contact information
Practice address
1700 EDMONDSON AVE, BALTIMORE, MD 21223-1212
(410) 523-5900
(410) 523-5939
Mailing address
16 KIMBERLYS CT, BALTIMORE, MD 21244-4007
(410) 523-5900
(410) 523-5939
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P04454
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011483900
—
MD
01
—
2126301
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/14/2006
Last updated
09/20/2012
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