Organization
KLEINS BROADWAY & MAIN INC
Active
Organization
KLEINS BROADWAY & MAIN INC
Active
Other names
Klein's Shoprite Pharmacy #547
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
223 N MAIN ST, BEL AIR, MD 21014-3501
(410) 630-0600
(410) 638-6469
Mailing address
223 N MAIN ST, BEL AIR, MD 21014-3501
(410) 630-0600
(410) 638-6469
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P01415
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2116538
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
528282900
—
MD
Enumeration date
08/24/2006
Last updated
08/26/2009
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