Healthcare Provider Details

I. General information

NPI: 1982743399
Provider Name (Legal Business Name): PAPER MILL PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 PAPER MILL RD
PHOENIX MD
21131-1419
US

IV. Provider business mailing address

3320 PAPER MILL RD
PHOENIX MD
21131-1419
US

V. Phone/Fax

Practice location:
  • Phone: 410-667-4600
  • Fax: 410-667-4716
Mailing address:
  • Phone: 410-667-4600
  • Fax: 410-667-4716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP02329
License Number StateMD

VIII. Authorized Official

Name: MR. DAVID ALAN PERROTT
Title or Position: PRESIDENT OWNER
Credential: R.PH.
Phone: 410-667-4600