Provider Demographics
NPI:1194927996
Name:FELLS POINT PHARMACY INC.
Entity type:Organization
Organization Name:FELLS POINT PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLAIDE
Authorized Official - Middle Name:
Authorized Official - Last Name:AJEIGBE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:240-398-9172
Mailing Address - Street 1:1704 FLEET ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-2916
Mailing Address - Country:US
Mailing Address - Phone:443-320-0704
Mailing Address - Fax:
Practice Address - Street 1:1704 FLEET ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231-2916
Practice Address - Country:US
Practice Address - Phone:443-320-0704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP045593336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy