Organization
JOHN WAYNE PHARMACY LLC
Active
Parent organization
JOHN WAYNE PHARMACY LLC
Other names
Professional Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
JOHN WAYNE PHARMACY LLC
Authorized official
MR. WAYNE D. VANWIE P.D. (PHARMACIST/OWNER)
(410) 687-8113
Entity
Organization
Contact information
Practice address
9106 PHILADELPHIA ROAD, SUITE #100, BALTIMORE, MD 21237
(410) 687-8113
(410) 391-3922
Mailing address
9106 PHILADELPHIA ROAD, SUITE #100, BALTIMORE, MD 21237
(410) 687-8113
(410) 391-3922
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
MD11499
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
700301300
—
MD
Enumeration date
11/26/2014
Last updated
11/26/2014
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