Organization
REHOBOTH HEALTHCARE SERVICES
Active
Other names
Owings Mills Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN TANON (DIRECTOR)
(443) 352-3818
Entity
Organization
Contact information
Practice address
10085 RED RUN BLVD STE 104, SUITE 104, OWINGS MILLS, MD 21117-4811
(443) 352-3818
(443) 379-0051
Mailing address
10085 RED RUN BLVD, SUITE 104, OWINGS MILLS, MD 21117-4836
(443) 352-3818
(443) 379-0051
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
P07055
MD
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1087894
—
MD
01
—
2159837
PK
—
Enumeration date
04/19/2016
Last updated
09/02/2016
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