Provider Demographics
NPI:1962796037
Name:CLARY, LINDA G (RPH)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:G
Last Name:CLARY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5230 CAMPBELL BLVD
Mailing Address - Street 2:T-1001
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4983
Mailing Address - Country:US
Mailing Address - Phone:410-933-9680
Mailing Address - Fax:410-933-9680
Practice Address - Street 1:5230 CAMPBELL BLVD
Practice Address - Street 2:T-1001
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-4983
Practice Address - Country:US
Practice Address - Phone:410-933-9680
Practice Address - Fax:410-933-9680
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11165183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist