Organization
INDEPENDENT DRUG IMMUNIZATION LLC
Active
Parent organization
INDEPENDENT DRUG
Other names
Marelaine Inc
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDEPENDENT DRUG
Authorized official
GEORGE GARMER (PRESIDENT)
(410) 207-5751
Entity
Organization
Contact information
Practice address
28 KINGSTON RD, BALTIMORE, MD 21220-4814
(410) 687-1115
(410) 687-0032
Mailing address
28 KINGSTON RD, BALTIMORE, MD 21220-4814
(410) 687-1115
(410) 687-0032
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P04009
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404088100
—
MD
Enumeration date
05/21/2014
Last updated
05/21/2014
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