Provider Demographics
NPI:1104609452
Name:SOLEIL PHARMACY
Entity type:Organization
Organization Name:SOLEIL PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:TRIEU
Authorized Official - Middle Name:
Authorized Official - Last Name:BAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-281-9157
Mailing Address - Street 1:801 LANDMARK DR STE B
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4986
Mailing Address - Country:US
Mailing Address - Phone:443-281-9157
Mailing Address - Fax:410-582-8728
Practice Address - Street 1:801 LANDMARK DR STE B
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4986
Practice Address - Country:US
Practice Address - Phone:443-281-9157
Practice Address - Fax:410-582-8728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy