Provider Demographics
NPI:1033480090
Name:PARKVILLE PHARMACY INC
Entity Type:Organization
Organization Name:PARKVILLE PHARMACY INC
Other - Org Name:HILLENDALE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:ANWAR
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSUF
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:410-599-5943
Mailing Address - Street 1:6875 LOCH RAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-8302
Mailing Address - Country:US
Mailing Address - Phone:410-825-0101
Mailing Address - Fax:
Practice Address - Street 1:6875 LOCH RAVEN BLVD
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-8302
Practice Address - Country:US
Practice Address - Phone:410-825-0101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12345333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy