Organization
PARKVILLE PHARMACY LLC
Active
Other names
PARKVILLE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KISHOR BUPATHI (CFO)
(443) 290-4867
Entity
Organization
Contact information
Practice address
8118 HARFORD RD, STE B, PARKVILLE, MD 21234-5725
(443) 290-4867
(443) 290-4868
Mailing address
8118 HARFORD RD, SUITE B, PARKVILLE, MD 21234-5725
(443) 290-4867
(443) 290-4868
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P06486
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0862215
—
MD
01
—
2148556
PK
—
Enumeration date
11/10/2014
Last updated
02/27/2017
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