Daniel Kovacic
Individual provider Active NPI Pharmacist · Middletown, MD
NPI 1194133975 · NPPES record last updated Jul 24, 2014
Key facts
- NPI
- 1194133975
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 11444 (MD)
- Practice address
- 805 E Main St
Middletown, MD 21769-7722 - Phone
- (301) 371-4100
- Fax
- (301) 371-8295
- NPI assigned
- Jul 24, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11444 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maryland CVS Pharmacy LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11444 | MD | Yes |
Addresses
Primary practice location
805 E Main St
Middletown, MD 21769-7722
Mailing address
805 E Main St
Middletown, MD 21769-7722
Phone (301) 371-4100
Other providers in Middletown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.