Active NPI
Andrea Park
- Pharmacist
- Salisbury, MD
National Provider Identifier
1508305749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 24704
- Practice address
- 833 S Salisbury Blvd
Salisbury, MD 21801-6207 - Phone
- (443) 260-0722
- NPI assigned
- Feb 21, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 24704 | MD | Primary |
Addresses
Primary practice location
833 S Salisbury Blvd
Salisbury, MD 21801-6207
Mailing address
833 S Salisbury Blvd
Salisbury, MD 21801-6207
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24704 | MD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eckerd Corporation | Past | Accepting new patients | |
| Eckerd Corporation | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Salisbury, MD
- NPI 1457450652
-
- Community/Retail Pharmacy
- Virginia Beach, VA
- NPI 1982703120
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487635200000",
"number": "1508305749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "833 S SALISBURY BLVD",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218016207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "833 S SALISBURY BLVD",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218016207",
"telephone_number": "443-260-0722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "ANDREA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-21",
"last_updated": "2017-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "24704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.