Organization
SARAH786 INC
Active
Other names
PATTERSON PARK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SYED SHAH (PRESIDENT)
(954) 288-5257
Entity
Organization
Contact information
Practice address
2245 EASTERN AVE, BALTIMORE, MD 21231-3113
(410) 675-6046
(410) 563-1147
Mailing address
2245 EASTERN AVE, BALTIMORE, MD 21231-3113
(410) 675-6046
(410) 563-1147
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHNR001430
GA
3336C0003X
Community/Retail Pharmacy
214001717
VA
3336C0003X
Community/Retail Pharmacy
NP000629
PA
3336C0003X
Community/Retail Pharmacy
Primary
NRX0000846
DC
3336C0003X
Community/Retail Pharmacy
P05416
MD
3336C0004X
Compounding Pharmacy
64001534A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
082807400
—
DC
01
—
2127929
PK
—
05
—
420485900
—
MD
Enumeration date
12/01/2010
Last updated
07/19/2018
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