College Park Pharmacy

LBN: Premium Pharmacy Services Inc
College Park Pharmacy is an health care organization with primary practice located at 4701 Melbourne Pl , College Park MD 20740-2540. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Premium Pharmacy Services Inc can be contacted via phone (301) 474-0500, or through Ayuk, Vivian via phone (240) 223-7064.

Contact Information

Primary practice address
4701 Melbourne Pl College Park MD 20740-2540
Phone: (301) 474-0500
Fax: (301) 474-0550
Website:
Map and Directions
Authorized official contact:
Name: Ayuk, Vivian RPH
Phone: (240) 223-7064

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X P07420 Maryland

Profile Details

NPI number 1902258130
LBN Legal business name Premium Pharmacy Services Inc
DBA Doing business as College Park Pharmacy
Authorized official Ayuk, Vivian RPH
Entity Organization
Organization subpart 1 No
Enumeration date Jul 12th, 2016
Last updated Apr 12th, 2017 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902258130 NPPES
Other 2162506 PK
MEDICAID 1159852 PK

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