IndividualActive
Ellison Park, PHARMD
NPI 1053904474 · Pharmacist · Randallstown, MD
Ellison Park, PHARMD is a Pharmacist provider in Randallstown, MD (NPI 1053904474).
Provider details
- NPI number
- 1053904474
- Entity type
- Individual
- Primary specialty
- PharmacistPharmacy Service Providers
- Credential
- PHARMD
- Sex
- Male
- Sole proprietor
- No
- License
- 27818 (MD)
Specialties & taxonomies
Pharmacy Service Providers
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
9110 Liberty Rd
Randallstown, MD 21133-3522
Phone: (410) 496-8146
Street-level locationGet directions
Mailing address
3925 Beech Ave Apt 211
Baltimore, MD 21211-2254
Registry dates
- Enumerated
- 2021-02-17
- Last updated
- 2021-02-17
- Certified
- 2021-02-12
Frequently asked questions
- What is Ellison Park's NPI number?
- Ellison Park's National Provider Identifier (NPI) is 1053904474, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Ellison Park's specialty?
- Ellison Park is listed in the NPPES registry with a primary specialty of Pharmacist (Pharmacy Service Providers).
- Where is Ellison Park located?
- Ellison Park's practice location on file with NPPES is 9110 Liberty Rd, Randallstown, MD 21133-3522.
- What is Ellison Park's phone number?
- The practice phone number listed in the NPPES registry for Ellison Park is (410) 496-8146.
- Is Ellison Park's NPI active?
- Yes — Ellison Park's NPI (1053904474) is active in the NPPES registry as of the last update on 2021-02-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.