Organization
WHITE MARSH PHARMACY
Active
Other names
WHITE MARSH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL SOURANIS RPH (OWNER)
(443) 384-2500
Entity
Organization
Contact information
Practice address
4924 CAMPBELL BLVD, STE 120, NOTTINGHAM, MD 21236-5908
(443) 384-2500
(443) 384-2525
Mailing address
4924 CAMPBELL BLVD, STE 120, NOTTINGHAM, MD 21236-5908
(443) 384-2500
(443) 384-2525
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P04046
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001356100
—
MD
05
—
001469900
—
MD
01
—
2037824
PK
—
Enumeration date
11/01/2006
Last updated
06/21/2013
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