Organization
ZONETAK HEALTHCARE
Active
Other names
Zonetak Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NGUEGNI FOBI-TAKUSI (DIRECTOR OF PHARMACY)
(410) 363-8271
Entity
Organization
Contact information
Practice address
515 FAIRMOUNT AVE STE 130, TOWSON, MD 21286-8520
(410) 363-8271
(410) 363-8273
Mailing address
515 FAIRMOUNT AVE STE 130, TOWSON, MD 21286-8520
(410) 363-8271
(410) 363-8273
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P05648
MD
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051732100
—
MD
01
—
2133401
PK
—
Enumeration date
01/11/2012
Last updated
06/28/2016
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