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Organization

WHITEMARSH 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
4924 CAMPBELL BLVD, SUITE 120, NOTTINGHAM, MD 21236-5908
(443) 384-2500
(443) 384-2525
Mailing address
4924 CAMPBELL BLVD, SUITE 120, NOTTINGHAM, MD 21236-5908
(443) 384-2500
(443) 384-2525

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PO4046
MD
3336C0003X
Community/Retail Pharmacy
PO4046
MD

Other

Enumeration date
01/14/2008
Last updated
01/14/2008
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