Provider Demographics
NPI:1851523765
Name:PROFESSIONAL CARE PHARMACY INC
Entity Type:Organization
Organization Name:PROFESSIONAL CARE PHARMACY INC
Other - Org Name:PROFESSIONAL CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MILANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MULGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-983-1010
Mailing Address - Street 1:1514 REISTERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3814
Mailing Address - Country:US
Mailing Address - Phone:410-484-4801
Mailing Address - Fax:410-484-4803
Practice Address - Street 1:1514 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-3814
Practice Address - Country:US
Practice Address - Phone:410-484-4801
Practice Address - Fax:410-484-4803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-12
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDPW04663336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2121619OtherPK