Organization
KLEINS BROADWAY & MAIN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK ROBERT HENDERSON (PHARMACY DIRECTOR)
(410) 420-8220
Entity
Organization
Contact information
Practice address
5 BEL AIR SOUTH PKWY STE 301, BEL AIR, MD 21015-6087
(443) 512-8373
Mailing address
2101 ROCK SPRING RD, FOREST HILL, MD 21050-2617
(410) 420-8224
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
550692100
—
MD
Enumeration date
01/21/2020
Last updated
01/21/2020
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