Provider Demographics
NPI:1528522638
Name:FINKSBURG PHARMACY INC
Entity type:Organization
Organization Name:FINKSBURG PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:RAIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:CARY
Authorized Official - Suffix:IV
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:410-526-1055
Mailing Address - Street 1:2027 SUFFOLK RD STE 4
Mailing Address - Street 2:
Mailing Address - City:FINKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21048-1634
Mailing Address - Country:US
Mailing Address - Phone:410-526-1055
Mailing Address - Fax:410-526-5211
Practice Address - Street 1:2027 SUFFOLK RD STE 4
Practice Address - Street 2:
Practice Address - City:FINKSBURG
Practice Address - State:MD
Practice Address - Zip Code:21048-1634
Practice Address - Country:US
Practice Address - Phone:410-526-1055
Practice Address - Fax:410-526-5211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-23
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD000162700Medicaid