Organization
INTRADE INC
Active
Other names
CRAIN TOWERS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MANISH SHAH (OWNER PHARMACIST)
(410) 760-4595
Entity
Organization
Contact information
Practice address
1600 CRAIN HWY S, STE 110, GLEN BURNIE, MD 21061-5577
(410) 760-4595
(410) 760-1575
Mailing address
1600 CRAIN HWY S, STE 110, GLEN BURNIE, MD 21061-5577
(410) 760-4595
(410) 760-1575
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
P03144
MD
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000151100
—
MD
01
—
2037774
PK
—
Enumeration date
09/20/2006
Last updated
06/16/2016
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