Organization
CRYSTAL HEALTH SERVICES INC
Active
Other names
Newtown pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MANOJNA CHALASANI (PHARMACY MANAGER)
(410) 963-0444
Entity
Organization
Contact information
Practice address
9351 LAKESIDE BLVD STE 103, OWINGS MILLS, MD 21117-5063
(410) 363-8222
(410) 363-2133
Mailing address
9151 REISTERSTOWN RD, OWINGS MILLS, MD 21117-4503
(410) 363-8222
(410) 363-2133
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P05168
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2135019
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/04/2010
Last updated
05/04/2011
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