Organization
COVENANT FOOD STORES INC.
Active
Other names
covenant pharmacy/grocery
Organization subpart
No
Provider details
NPI number
Authorized official
MR. COLLINWISE OSEI-ABOAGYE RPH (PHARMACIST/PRESIDENT)
(301) 362-9100
Entity
Organization
Contact information
Practice address
14633 BALTIMORE AVE, LAUREL, MD 20707-4902
(301) 362-9100
(301) 362-9138
Mailing address
14633 BALTIMORE AVE, LAUREL, MD 20707-4902
(301) 362-9100
(301) 362-9138
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P04006
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00111850
—
MD
01
—
2127214
NCPDP
MD
Enumeration date
07/11/2006
Last updated
08/22/2020
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