Avalon Professional Pharmacy Llc

LBN: Avalon Professional Pharmacy Llc
Avalon Professional Pharmacy Llc is an health care organization with primary practice located at 12100 Annapolis Rd Unit 2 , Glenn Dale MD 20769. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Avalon Professional Pharmacy Llc can be contacted via phone (301) 383-0142, or through Maduka, Jason C via phone (301) 383-0142.

Contact Information

Primary practice address
12100 Annapolis Rd Unit 2 Glenn Dale MD 20769
Phone: (301) 383-0142
Fax: (301) 383-0143
Website:
Map and Directions
Authorized official contact:
Name: Maduka, Jason C RPH
Phone: (301) 383-0142

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1790564417
LBN Legal business name Avalon Professional Pharmacy Llc
DBA Doing business as
Authorized official Maduka, Jason C RPH
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 22nd, 2023
Last updated Mar 18th, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790564417 NPPES
Maryland MEDICAID 456105800

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