AVALON PROFESSIONAL PHARMACY LLC.
NPI 1003681016
Pharmacy - Community/Retail Pharmacy in Glenn Dale, MD

Active since November 20, 2023CLIA 21D2308888 · Waiver
12100 ANNAPOLIS RD UNIT 2, GLENN DALE, MD 20769(301) 383-0142(301) 383-0143 Get Directions Write a Review

NPPES record last updated: November 20, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Avalon Professional Pharmacy Llc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AVALON PROFESSIONAL PHARMACY LLC. (NPI 1003681016) is a healthcare organization registered as a community/retail pharmacy in Glenn Dale, Maryland and active in the NPI registry since November 2023. The organization holds a CLIA Waiver certificate valid through August 5, 2026 and lists Jason C Maduka, Pharmacy Owner/pharmacy Manager, as its authorized official.

NPPES Registry Identity

NPI1003681016
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameAVALON PROFESSIONAL PHARMACY LLC.
Location Address12100 ANNAPOLIS RD UNIT 2Glenn Dale, MD 20769
Mailing Address12100 Annapolis Rd Unit 2Glenn Dale, MD 20769 · (301) 383-0142 · Fax (301) 383-0143
Fax(301) 383-0143
Organization SubpartYesParent: Avalon Marketing Inc
Authorized OfficialJason C MadukaPharmacy Owner/pharmacy Manager · (310) 383-0142
Enumeration DateNovember 20, 2023
NPI 1003681016 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

12100 ANNAPOLIS RD UNIT 2, Glenn Dale, MD 20769

Other Identifiers 1

Medicaid456105800MD

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D2308888

Avalon Professional Pharmacy · Glenn Dale, MD
Active · expires Aug 5, 2026
CLIA Number21D2308888
Laboratory TypePhysician Office
Certificate Effective DateAugust 6, 2024
Certificate Expiration DateAugust 5, 2026
Laboratory DirectorMary Spencer
Laboratory Phone(301) 383-0142
Laboratory LocationAvalon Professional Pharmacy12100 Annapolis Rd Unit #2, Glenn Dale, MD 20769
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Psychiatric/Mental Health)
12100 ANNAPOLIS RD UNIT 2
GLENN DALE, MD 20769
Pharmacy (Long Term Care Pharmacy)
12100 ANNAPOLIS RD UNIT 2
GLENN DALE, MD 20769

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Avalon Professional Pharmacy LLC.'s NPI number?

The NPI number for Avalon Professional Pharmacy LLC. is 1003681016. It was assigned to this organization in the NPPES registry on November 20, 2023.

Where is Avalon Professional Pharmacy LLC. located?

Avalon Professional Pharmacy LLC. is located at 12100 Annapolis Rd Unit 2, Glenn Dale, MD 20769. The listed phone number is (301) 383-0142.

What is Avalon Professional Pharmacy LLC.'s specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Avalon Professional Pharmacy LLC. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2308888) is associated with this NPI, valid through August 5, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Avalon Professional Pharmacy LLC. was last updated on November 20, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.