Organization
AVALON PROFESSIONAL PHARMACY LLC.
Active
Organization
AVALON PROFESSIONAL PHARMACY LLC.
Active
Parent organization
AVALON MARKETING INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AVALON MARKETING INC
Authorized official
MR. JASON C MADUKA RPH (PHARMACY OWNER/PHARMACY MANAGER)
(310) 383-0142
Entity
Organization
Contact information
Practice address
12100 ANNAPOLIS RD UNIT 2, GLENN DALE, MD 20769
(301) 383-0142
(301) 383-0143
Mailing address
12100 ANNAPOLIS RD UNIT 2, GLENN DALE, MD 20769
(301) 383-0142
(301) 383-0143
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
456105800
—
MD
Enumeration date
11/20/2023
Last updated
11/20/2023
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