Provider Demographics
NPI:1134967623
Name:QAULITY CARE PHARMACY
Entity type:Organization
Organization Name:QAULITY CARE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:UCHENNA
Authorized Official - Middle Name:P
Authorized Official - Last Name:EKWUNAZU
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:443-835-4472
Mailing Address - Street 1:1403 E COLD SPRING LANE
Mailing Address - Street 2:STE B
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239
Mailing Address - Country:US
Mailing Address - Phone:443-835-4472
Mailing Address - Fax:410-864-8941
Practice Address - Street 1:1403 E COLDSPRING LANE
Practice Address - Street 2:STE B
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239
Practice Address - Country:US
Practice Address - Phone:410-800-4886
Practice Address - Fax:410-864-8941
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PACC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD028969800Medicaid