Organization
HIGHLANDTOWN PHARMACY INC
Active
Other names
Highlandtown Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
VINAY KUMAR DASARI (MANAGER)
(667) 212-3621
Entity
Organization
Contact information
Practice address
3911 EASTERN AVE, BALTIMORE, MD 21224-4224
(667) 212-3621
(667) 212-3623
Mailing address
3911 EASTERN AVE, BALTIMORE, MD 21224-4224
(667) 212-3621
(667) 212-3623
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P06471
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2148130
PK
—
Enumeration date
08/04/2014
Last updated
12/13/2016
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