1801871280 NPI number — DR. JASON MICHAEL NOEL PHARM.D.

Table of content: JACLYN MARIE SMITH R.D. (NPI 1639315054)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801871280 NPI number — DR. JASON MICHAEL NOEL PHARM.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NOEL
Provider First Name:
JASON
Provider Middle Name:
MICHAEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801871280
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/08/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 N PINE ST
Provider Second Line Business Mailing Address:
S 428
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21201-1142
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-706-7139
Provider Business Mailing Address Fax Number:
410-706-0319

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
55 WADE AVE
Provider Second Line Business Practice Location Address:
PHARMACY DEPARTMENT
Provider Business Practice Location Address City Name:
CATONSVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21228-4663
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-402-7816
Provider Business Practice Location Address Fax Number:
410-402-7990
Provider Enumeration Date:
12/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P1300X , with the licence number:  15492 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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