Healthcare Provider Details

I. General information

NPI: 1093894768
Provider Name (Legal Business Name): MYVEL ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 12/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 E FREDERICK ST
WALKERSVILLE MD
21793-8234
US

IV. Provider business mailing address

19 E FREDERICK ST
WALKERSVILLE MD
21793-8234
US

V. Phone/Fax

Practice location:
  • Phone: 301-845-4401
  • Fax: 301-845-1114
Mailing address:
  • Phone: 301-845-4401
  • Fax: 301-845-1114

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 NumberP04478
License Number StateMD

VIII. Authorized Official

Name: GNANAVEL MUNIRATHINAM
Title or Position: PRESIDENT REGSTRD PHARMACIST
Credential:
Phone: 301-845-4401