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General NPI Number Information
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NPI Number | 1033480090
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Entity Type | Organization
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Legal Business Name | PARKVILLE PHARMACY INC
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Dates
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Enumeration Date | 01/24/2012
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Last Update Date | 01/24/2012
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Provider Practice Location Address
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Address Line | 6875 LOCH RAVEN BLVD
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City | TOWSON
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State | MD
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Zip | 21286-8302
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Country | US
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Telephone | 410-825-0101
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Fax |
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Provider Business Mailing Address
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Address Line | 6875 LOCH RAVEN BLVD
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City | TOWSON
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State | MD
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Zip | 21286-8302
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Country | US
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Telephone | 410-825-0101
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MR. ANWAR YOUSUF
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Credential | PHARMD
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Telephone | 410-599-5943
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 12345
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License Number State | MD
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