Lee Ahlstrom, RPH
Individual provider Active NPI Pharmacist · Berlin, MD
NPI 1902185697 · NPPES record last updated Aug 11, 2011
Key facts
- NPI
- 1902185697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 07472 (MD)
- Practice address
- 11307 Manklin Creek Rd
Berlin, MD 21811 - Phone
- (410) 208-3811
- NPI assigned
- Aug 11, 2011
- Sex
- Male
- Sole proprietor
- Yes
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07472 | MD | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Happy Harrys Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 07472 | MD | Yes |
Addresses
Primary practice location
11307 Manklin Creek Rd
Berlin, MD 21811
Mailing address
6 Alton PT
Berlin, MD 21811-1739
Phone (410) 208-1249
Other providers in Berlin, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2011. 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.