Organization
SHOPRITE OF LIBERTY HEIGHTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK ROBERT HENDERSON (PHARMACY DIRECTOR)
(410) 420-8220
Entity
Organization
Contact information
Practice address
4601 LIBERTY HEIGHTS AVE, BALTIMORE, MD 21207-7553
(410) 367-1850
Mailing address
2101 ROCK SPRING RD, FOREST HILL, MD 21050-2617
(410) 420-8224
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079663800
—
MD
Enumeration date
01/21/2020
Last updated
01/21/2020
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