Organization
CITICARE PHARMACY AND MEDICAL EQUIPMENT, LLC
Active
Other names
Citicare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DEJI OLADAPO (PHARMACY MANAGER)
(410) 261-5551
Entity
Organization
Contact information
Practice address
3403 GREENMOUNT AVE, BALTIMORE, MD 21218-2824
(410) 261-5551
Mailing address
3403 GREENMOUNT AVE, BALTIMORE, MD 21218-2824
(410) 261-5551
(410) 261-5553
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07173
MD
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2159722
PK
—
Enumeration date
04/09/2016
Last updated
07/10/2019
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