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Individual

MATTHEW BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPHT

Contact information

Practice address
45155 FIRST COLONY WAY, ATTN PHARMACY, CALIFORNIA, MD 20619-2416
(301) 862-5342
Mailing address
45155 FIRST COLONY WAY, ATTN PHARMACY, CALIFORNIA, MD 20619-2416
(301) 862-5342

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
0230022207
VA
183700000X
Pharmacy Technician
Primary
T08958
MD

Other

Enumeration date
02/02/2015
Last updated
02/02/2015
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