Organization
OLD COURT PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMEKA NWODIM (PHARMACIST)
(410) 521-9520
Entity
Organization
Contact information
Practice address
8607 LIBERTY RD, RANDALLSTOWN, MD 21133-4713
(443) 301-9306
(410) 521-9521
Mailing address
8607 LIBERTY RD, RANDALLSTOWN, MD 21133-4713
(443) 301-9306
(410) 521-9521
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2123127
OTHER ID NUMBER
—
05
—
233602200
—
MD
Enumeration date
11/03/2021
Last updated
11/03/2021
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