Organization
MARYLAND SPECIALTY AND COMPOUNDING PHARMACY LLC
Active
Other names
Professional Arts Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THAI HUYNH PHARMD (OWNER)
(404) 514-2016
Entity
Organization
Contact information
Practice address
3138 ROGERS AVE, ELLICOTT CITY, MD 21043-3320
(443) 200-1200
(443) 252-8093
Mailing address
3138 ROGERS AVE, ELLICOTT CITY, MD 21043-3320
(443) 200-1200
(443) 252-8093
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
P07718
MD
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720582893
NPI
MD
01
—
2142379
NCPDP NUMBER
MD
01
—
2176312
PK
—
05
—
543121200
—
MD
Enumeration date
03/22/2018
Last updated
05/08/2020
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