Active NPI
Bukola Thelma Nwadibia
- Pharmacist
- Hyattsville, MD
National Provider Identifier
1033972864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 29630
- Practice address
- 3605 E West Hwy
Hyattsville, MD 20782-2006 - Phone
- (301) 277-0199
- NPI assigned
- Feb 5, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 29630 | MD | Primary |
Addresses
Primary practice location
3605 E West Hwy
Hyattsville, MD 20782-2006
Mailing address
3605 E West Hwy
Hyattsville, MD 20782-2006
Phone (301) 277-0199
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29630 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maryland CVS Pharmacy, L.L.C. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707091200000",
"number": "1033972864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3605 E WEST HWY",
"city": "HYATTSVILLE",
"state": "MD",
"postal_code": "207822006",
"telephone_number": "301-277-0199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3605 E WEST HWY",
"city": "HYATTSVILLE",
"state": "MD",
"postal_code": "207822006",
"telephone_number": "301-277-0199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NWADIBIA",
"first_name": "BUKOLA",
"middle_name": "THELMA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-05",
"last_updated": "2024-02-05",
"certification_date": "2024-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "29630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hyattsville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.