Organization
PAX PHARMACY LLC
Active
Other names
Pax Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GLADSTONE ATTIPOE (PHARMACIST)
(301) 490-1170
Entity
Organization
Contact information
Practice address
9900 WASHINGTON BLVD N STE G, LAUREL, MD 20723-1972
(301) 490-1170
(301) 490-1186
Mailing address
9900 WASHINGTON BLVD N STE G, LAUREL, MD 20723-1972
(301) 490-1170
(301) 490-1186
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P06919
MD
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2158118
PK
—
Enumeration date
01/11/2016
Last updated
05/12/2016
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