NPI 1790564417

Avalon Professional Pharmacy LLC

Organisation Long Term Care Pharmacy Glenn Dale, MD

Practice location

Address: 12100 Annapolis Rd Unit 2, Glenn Dale, MD 20769
Phone: (301) 383-0142
Fax: (301) 383-0143

Authorised official

Name: Jason C Maduka
Title: Pharmacy Owner/Pharmacy Manager
Phone: (301) 383-0142

Registered specialties

Long Term Care Pharmacy Primary

Suppliers Taxonomy 3336L0003X

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Registry record

NPI: 1790564417
Entity type: Organization
NPI issued: 22 Sep 2023
Record last updated: 8 Dec 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.