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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