Taiwo Adebesin, RPH
Individual provider Active NPI Pharmacist · Laurel, MD
NPI 1184024366 · NPPES record last updated Aug 26, 2014
Key facts
- NPI
- 1184024366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 12755 (MD)
- Practice address
- 320 Domer Ave
Laurel, MD 20707-4804 - Phone
- (301) 776-7514
- NPI assigned
- Aug 26, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12755 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maryland CVS Pharmacy, L.L.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12755 | MD | Yes |
Addresses
Primary practice location
320 Domer Ave
Laurel, MD 20707-4804
Mailing address
320 Domer Ave
Laurel, MD 20707-4804
Phone (301) 776-7514
Other providers in Laurel, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.