Omega Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301009758 Issued in MI

Legal business name

OMEGA PHARMACY LLC

Doing business as

Omega Pharmacy

Practice address

420 W Huron St
Pontiac, MI 48341-1425

Phone

(248) 481-9004

Fax

(248) 481-9168

NPI assigned

Feb 16, 2012

Last updated

Dec 8, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ayodeji AbejideNPI 1275817405

Title

Chief Executive Officer

Phone

(586) 945-1778

Specialties & licenses 7

Addresses

Other identifiers 2

Other names 1

• Omega Pharmacy Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ayodeji Eyitayo Abejide

  • Pharmacist
  • Pontiac, MI
  • NPI 1275817405
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1114290582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W HURON ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411425",
            "telephone_number": "248-481-9004",
            "fax_number": "248-481-9168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W HURON ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411425",
            "telephone_number": "248-481-9004",
            "fax_number": "248-481-9168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMEGA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-16",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "ABEJIDE",
        "authorized_official_first_name": "AYODEJI",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "586-945-1778"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009758",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2134037",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114290582",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omega Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ayomide Oyindamola Ojo, MD
• Micaela Olivas, LLMSW
• Olamide Ologundudu
• Natalie Oltean, FNP-BC
• Debbie Olter
• Omega Pharmacy LLC (Omega Pharmacy II)
• Omote RX Inc
• One Call Staffing
• Felecia Ann Oneal
• Opdyke Medical, PLLC

• Community/Retail Pharmacy in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.