Healthcare Provider Details

I. General information

NPI: 1134587371
Provider Name (Legal Business Name): PATIENT CARE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2016
Last Update Date: 08/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2047 WEST ST SUITE A
ANNAPOLIS MD
21401-3006
US

IV. Provider business mailing address

2047 WEST ST SUITE A
ANNAPOLIS MD
21401-3006
US

V. Phone/Fax

Practice location:
  • Phone: 443-949-9005
  • Fax: 443-949-9152
Mailing address:
  • Phone: 443-949-9005
  • Fax: 443-949-9152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP07157
License Number StateMD

VIII. Authorized Official

Name: VAIBHAV PATEL
Title or Position: OWNER, PIC
Credential:
Phone: 443-716-6038