Organization
PARADIGM PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEON JAY VANDENBERG RPH (PRESIDENT)
(410) 729-2131
Entity
Organization
Contact information
Practice address
408 HEADQUARTERS DR, SUITE 5, MILLERSVILLE, MD 21108-2550
(410) 729-2131
(410) 729-1118
Mailing address
408 HEADQUARTERS DR, SUITE 5, MILLERSVILLE, MD 21108-2550
(410) 729-2131
(410) 729-1118
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PW0212
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F869
FEP
MD
01
—
MK48
BLUE CROSS BLUE SHIELD
MD
Enumeration date
06/02/2006
Last updated
12/04/2007
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