Provider Demographics
NPI:1376211219
Name:GILK, PAIGE NEELY (PHARMD)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:NEELY
Last Name:GILK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16908 REVERE RD
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-7095
Mailing Address - Country:US
Mailing Address - Phone:219-484-6147
Mailing Address - Fax:
Practice Address - Street 1:1650C WESEL BLVD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5387
Practice Address - Country:US
Practice Address - Phone:301-990-3150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28207183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist