Organization
MARYLAND SPECIALTY AND COMPOUNDING PHARMACY LLC
Active
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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