Provider Demographics
NPI:1144940313
Name:CASTILLO-GARCIA, ELISA (PHARM D)
Entity type:Individual
Prefix:
First Name:ELISA
Middle Name:
Last Name:CASTILLO-GARCIA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6636 WASHINGTON BLVD TRLR 87
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6015
Mailing Address - Country:US
Mailing Address - Phone:301-531-0665
Mailing Address - Fax:
Practice Address - Street 1:28 MAGOTHY BEACH RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-4428
Practice Address - Country:US
Practice Address - Phone:410-437-6450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28755183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist