Provider Demographics
NPI:1386878841
Name:GHODS, MARY P (RPH)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:P
Last Name:GHODS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:P
Other - Last Name:GHODSNASIRABADI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:9717 KEY WEST AVENUE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3982
Mailing Address - Country:US
Mailing Address - Phone:301-337-4200
Mailing Address - Fax:301-337-4135
Practice Address - Street 1:9717 KEY WEST AVENUE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3982
Practice Address - Country:US
Practice Address - Phone:301-337-4200
Practice Address - Fax:301-337-4135
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10914183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist