Organization
COLUMBIA HICKORY PHARMACY INC
Active
Organization
COLUMBIA HICKORY PHARMACY INC
Active
Other names
COLUMBIA HICKORY CARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
HYUNG J NA (PRESIDENT)
(410) 964-6409
Entity
Organization
Contact information
Practice address
10805 HICKORY RIDGE RD, SUITE 2, COLUMBIA, MD 21044-3626
(410) 964-6409
(410) 964-6493
Mailing address
10805 HICKORY RIDGE RD, SUITE 2, COLUMBIA, MD 21044-3626
(410) 964-6409
(410) 964-6493
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P04190
MD
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2037991
PK
—
05
—
407608700
—
MD
Enumeration date
09/21/2005
Last updated
12/02/2020
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