Provider Demographics
NPI:1093894768
Name:MYVEL ASSOCIATES INC
Entity Type:Organization
Organization Name:MYVEL ASSOCIATES INC
Other - Org Name:WALKERSVILLE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT REGSTRD PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:GNANAVEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNIRATHINAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-845-4401
Mailing Address - Street 1:19 E FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:WALKERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21793-8234
Mailing Address - Country:US
Mailing Address - Phone:301-845-4401
Mailing Address - Fax:301-845-1114
Practice Address - Street 1:19 E FREDERICK ST
Practice Address - Street 2:
Practice Address - City:WALKERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21793-8234
Practice Address - Country:US
Practice Address - Phone:301-845-4401
Practice Address - Fax:301-845-1114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2016-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MDP044783336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2036362OtherPK
MD5786520001Medicare NSC
MD214820000Medicaid