Organization
EASTERN AVENUE PHARMACY AND MEDICAL EQUIPMENT, LLC
Active
Organization
EASTERN AVENUE PHARMACY AND MEDICAL EQUIPMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADJARHO EGBEGBADIA (MANAGER)
(410) 929-8455
Entity
Organization
Contact information
Practice address
5901 EASTERN AVE, D, BALTIMORE, MD 21224
(410) 929-8455
(410) 929-8368
Mailing address
5901 EASTERN AVE., SUITE D, BALTIMORE, MD 21224-2731
(410) 929-8455
(410) 929-8368
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P06257
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P06257
MDBOP
MD
Enumeration date
09/27/2013
Last updated
04/23/2014
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