Organization
BAYVIEW PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL N SOURANIS P.D. (PRESIDENT)
(410) 633-5050
Entity
Organization
Contact information
Practice address
6510 ODONNELL ST, BALTIMORE, MD 21224-4643
(410) 633-5050
(410) 633-5188
Mailing address
6510 ODONNELL ST, BALTIMORE, MD 21224-4643
(410) 633-5050
(410) 633-5188
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PO1845
MD
3336C0003X
Community/Retail Pharmacy
PO1845
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
325838600
—
MD
Enumeration date
01/14/2008
Last updated
01/14/2008
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