Organization
CONTRACT PHARMACY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE SHAFER (OWNER)
(267) 487-8900
Entity
Organization
Contact information
Practice address
7200 THIRD AVE, ELDERSBURG, MD 21784-5201
(410) 549-8922
(410) 549-3677
Mailing address
125 TITUS AVE, WARRINGTON, PA 18976-2424
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336I0012X
Institutional Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PW0278
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010337300
—
MD
01
—
2125183
OTHER ID NUMBER
—
Enumeration date
07/26/2006
Last updated
06/26/2008
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