Provider Demographics
NPI:1063791630
Name:SHULTZ, ALLISON MARGARET (PHARMD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARGARET
Last Name:SHULTZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:MARGARET
Other - Last Name:ARICO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16 CANDICE DRIVE
Mailing Address - Street 2:
Mailing Address - City:PORT DEPOSIT
Mailing Address - State:MD
Mailing Address - Zip Code:21904
Mailing Address - Country:US
Mailing Address - Phone:518-588-7090
Mailing Address - Fax:
Practice Address - Street 1:225 BRIERHILL DR
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-4941
Practice Address - Country:US
Practice Address - Phone:410-420-2053
Practice Address - Fax:410-420-2057
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2019-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20321183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist