Organization
LIBERTY PHARMACY LLC
Active
Other names
LIBERTY PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KINGSLEY NEBOH (OWNER/PHARMACIST)
(240) 547-8698
Entity
Organization
Contact information
Practice address
108 N EUTAW ST, BALTIMORE, MD 21201-2154
(443) 948-5400
(443) 948-5408
Mailing address
108 N EUTAW ST, BALTIMORE, MD 21201-2154
(443) 948-5400
(443) 948-5408
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07520
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2168825
PK
—
Enumeration date
04/11/2017
Last updated
04/11/2017
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