Individual
ALAN JOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
5624 BALTIMORE NATIONAL PIKE, BALTIMORE, MD 21228-1418
(410) 719-7608
Mailing address
6016 AUGUSTINE AVE, ELKRIDGE, MD 21075-5351
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28263
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28263
IMMUNIZING PHARMACIST
MD
Enumeration date
11/30/2021
Last updated
11/30/2021
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