Healthcare Provider Details

I. General information

NPI: 1144940313
Provider Name (Legal Business Name): ELISA CASTILLO-GARCIA PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 MAGOTHY BEACH RD
PASADENA MD
21122-4428
US

IV. Provider business mailing address

6636 WASHINGTON BLVD TRLR 87
ELKRIDGE MD
21075-6015
US

V. Phone/Fax

Practice location:
  • Phone: 410-437-6450
  • Fax:
Mailing address:
  • Phone: 301-531-0665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28755
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: