Provider Demographics
NPI:1255474722
Name:MCDOUGALL'S PHARMACY INC.
Entity type:Organization
Organization Name:MCDOUGALL'S PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:MCDOUGALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-795-2255
Mailing Address - Street 1:1380 PROGRESS WAY
Mailing Address - Street 2:#115
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6464
Mailing Address - Country:US
Mailing Address - Phone:410-795-2255
Mailing Address - Fax:410-795-9060
Practice Address - Street 1:1380 PROGRESS WAY
Practice Address - Street 2:#115
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-6464
Practice Address - Country:US
Practice Address - Phone:410-795-2255
Practice Address - Fax:410-795-9060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP004273336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2104583OtherNABP #