Provider Demographics
NPI:1699753541
Name:HARFORD PHARMACY INC
Entity type:Organization
Organization Name:HARFORD PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:TRISTANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-838-0990
Mailing Address - Street 1:1510 CONOWINGO RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-1879
Mailing Address - Country:US
Mailing Address - Phone:410-838-0990
Mailing Address - Fax:410-836-8429
Practice Address - Street 1:1510 CONOWINGO RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-1879
Practice Address - Country:US
Practice Address - Phone:410-838-0990
Practice Address - Fax:410-836-8429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-02
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
MDP003143336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2033035OtherPK
MD453502200Medicaid
MD453502200Medicaid