Ellison Jinwoo Park, PHARMD
NPI 1053904474ActiveIndividual· Pharmacist· Randallstown, MD
Pharmacist (PHARMD) in Randallstown, Maryland, licensed in MD, with an NPI issued in February 2021. Part D covered 11 prescriptions written in 2024.
Overview
| NPI | 1053904474 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHARMD |
| Sole proprietor | No |
| NPI issued | Feb 17, 2021 |
| Last updated in NPPES | Feb 17, 2021 |
| Certified by provider | Feb 12, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacist Primary | 183500000X | 27818 | MD |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 11 · 12 30-day fills |
|---|---|
| Total drug cost | $2,372 |
Other Pharmacist providers in Randallstown
- 1770892762
- 1780852947
- 1366017428
- 1073894390
- 1386853869
- 1750595583
- 1003658063
- 1891391082
- 1134168792
- 1558421495
- 1225414600
- 1760083349