| NPI | 1821170614 |
|---|---|
| Doing Business As | PARK AVENUE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SYAM POTLURI Managing Member 443-823-3350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MD P06708) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2017-02-15 |