AVALON PROFESSIONAL PHARMACY LLC.

Community/Retail Pharmacy

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

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Contact Information

AVALON PROFESSIONAL PHARMACY LLC.

12100 ANNAPOLIS RD UNIT 2
GLENN DALE, MD 20769

Phone: 301-383-0142
Fax: 301-383-0143
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Community/Retail Pharmacy	3336C0003X	58	Medical Supply Company with Pharmacist

Indicates primary specialty

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NPI Profile & details for AVALON PROFESSIONAL PHARMACY LLC.

NPI Number 1003681016

LBN Legal business name AVALON PROFESSIONAL PHARMACY LLC.

Authorized official JASON MADUKA - (PHARMACY OWNER/PHARMACY MANAGER)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 11/20/2023

Last updated 11/20/2023 - About 3 years ago

Identifiers

Medicaid

456105800

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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