Provider Demographics
NPI:1801480884
Name:CLINIC PHARMACY, LLC
Entity type:Organization
Organization Name:CLINIC PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINITRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:OHIKU
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, CRNP, PMHNP
Authorized Official - Phone:443-551-3784
Mailing Address - Street 1:11 AYNESLEY COURT
Mailing Address - Street 2:OWINGS MILLS, 21117
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117
Mailing Address - Country:US
Mailing Address - Phone:410-404-7651
Mailing Address - Fax:
Practice Address - Street 1:1000 INGLESIDE AVE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-1317
Practice Address - Country:US
Practice Address - Phone:443-551-3784
Practice Address - Fax:443-551-3801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy