Healthcare Provider Details
I. General information
NPI: 1891815718
Provider Name (Legal Business Name): ROY VINCENT CASTLE JR. R.PH., P.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5600 FISHERS LN HFD-13
ROCKVILLE MD
20857-0001
US
IV. Provider business mailing address
19035 FESTIVAL DR
BOYDS MD
20841-4001
US
V. Phone/Fax
- Phone: 240-453-6689
- Fax: 240-453-6685
- Phone: 301-972-2394
- Fax: 301-972-2395
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 08969 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: