Provider Demographics
NPI:1316278047
Name:ARUNDEL MILLS PHARMACY LLC
Entity type:Organization
Organization Name:ARUNDEL MILLS PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OA
Authorized Official - Prefix:
Authorized Official - First Name:KUNJAL
Authorized Official - Middle Name:KIRAN
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:443-899-4775
Mailing Address - Street 1:1912 LIBERTY RD SPC 21
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6690
Mailing Address - Country:US
Mailing Address - Phone:443-899-4775
Mailing Address - Fax:443-899-4776
Practice Address - Street 1:1912 LIBERTY RD SPC 21
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-6690
Practice Address - Country:US
Practice Address - Phone:443-899-4775
Practice Address - Fax:443-899-4776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP050303336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2135071OtherNCPDP PROVIDER IDENTIFICATION NUMBER