NPIMap

Organization Active NPI

Avalon Marketing Inc

Doing business as Avalon Professional Pharmacy

  • Community/Retail Pharmacy
  • Glenn Dale, MD
National Provider Identifier
1942548367
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P05883 Issued in MD
Legal business name
AVALON MARKETING INC
Doing business as
Avalon Professional Pharmacy
Practice address
12100 Annapolis Road Unit 2
Glenn Dale, MD 20769
Phone
(301) 383-0142
Fax
(301) 383-0143
NPI assigned
Jan 18, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jason Chigozie Maduka, RPHNPI 1831499292
Title
Owner
Phone
(301) 383-0142

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X P05883 MD Primary

Addresses

Primary practice location

12100 Annapolis Road Unit 2
Glenn Dale, MD 20769

Mailing address

12100 Annapolis Road Unit 2
Glenn Dale, MD 20769
Phone (301) 383-0142

Other identifiers 1

IdentifierTypeStateIssuer
456105800MedicaidMD

Other names 1

  • Avalon Professional Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131007000057 DC Part B Supplier - Pharmacy 7719111707 Practice locations: Glenn Dale, MD

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765152000000",
    "number": "1942548367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12100 ANNAPOLIS ROAD UNIT 2",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "20769",
            "telephone_number": "301-383-0142",
            "fax_number": "301-383-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 ANNAPOLIS ROAD UNIT 2",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "20769",
            "telephone_number": "301-383-0142",
            "fax_number": "301-383-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON MARKETING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-18",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A",
        "authorized_official_last_name": "MADUKA",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "CHIGOZIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-383-0142",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P05883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "456105800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avalon Professional Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avalon Professional Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glenn Dale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.