Organization
GOVANS PROFESSIONAL PHARMACY
Active
Other names
GOVANS PROFESSIONAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE ANIFOWOSHE PHRM (OWNER)
(410) 532-9796
Entity
Organization
Contact information
Practice address
5109 YORK RD, BALTIMORE, MD 21212-4399
(410) 532-9796
(410) 532-6418
Mailing address
5109 YORK RD, BALTIMORE, MD 21212-4399
(410) 532-9796
(410) 532-6418
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P01126
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2033877
PK
—
05
—
272822000
—
MD
Enumeration date
11/08/2006
Last updated
10/07/2016
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