Organization
EMPIRE PROFESSIONAL PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEREMY CUNDIFF (PRESIDENT)
(410) 787-0030
Entity
Organization
Contact information
Practice address
200 HOSPITAL DR, STE 107, GLEN BURNIE, MD 21061-5884
(410) 787-0030
(410) 787-0030
Mailing address
200 HOSPITAL DR, STE 107, GLEN BURNIE, MD 21061-5884
(410) 787-0030
(410) 787-0033
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
P00948
MD
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2112009
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
256723000
—
MD
05
—
419578700
—
MD
Enumeration date
06/28/2006
Last updated
10/24/2017
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