Constance Mafor Tazem

Primary specialty

PharmacistTaxonomy code 183500000X

License

14348 Issued in MD

Practice address

150 Solomons Island Rd N
Prince Frederick, MD 20678-3906

Phone

(301) 221-0326

Fax

(410) 535-6590

NPI assigned

Oct 29, 2020

Last updated

Oct 29, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wal-Mart Stores East LP

  dba Walmart Pharmacy 10-1716

  • Community/Retail Pharmacy
  • Prince Frederick, MD
  • NPI 1992722268
  NPD (past)
• Wal-Mart Stores East, LP

  dba Walmart Pharmacy 10-2229

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1629678412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SOLOMONS ISLAND RD N",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783906",
            "telephone_number": "301-221-0326",
            "fax_number": "410-535-6590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SOLOMONS ISLAND RD N",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783906",
            "telephone_number": "301-221-0326",
            "fax_number": "410-535-6590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAZEM",
        "first_name": "CONSTANCE",
        "middle_name": "MAFOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "14348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Anne Tallent, PH.D
• Tallman Medical, LLC
• Chelsea Tarleton, LGSW
• Jennifer Diane Taubert, RN
• Angela Taylor, LCPC
• Vinod Kumar Thakur, PHARMACIST
• The Training Room Inc
• The Training Room Inc
• The Vine Christian Counseling, LLC
• Therapy Cafe LLC (Therapy Cafe)

• Pharmacist in Prince Frederick, MD
• Providers in Prince Frederick, MD by specialty
• Pharmacist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.