Olatunbosun Antonissen, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

15694 Issued in NC

Practice address

6805 Parker Farm Dr
Attention: Pharmacy
Wilmington, NC 28405-3168

Phone

(910) 256-4159

Fax

(910) 256-7868

NPI assigned

May 8, 2011

Last updated

Mar 7, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Olatunbosun Olatokunbo Antonissen Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Harris Teeter LLC

  dba Harris Teeter #335

  • Community/Retail Pharmacy
  • Apex, NC
  • NPI 1225856859
  NPD (past)
• Harris Teeter, LLC

  • Community/Retail Pharmacy
  • Wilmington, NC
  • NPI 1023101797
  NPD (past)

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

{
    "created_epoch": "1304812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394150400000",
    "number": "1215229331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6805 PARKER FARM DR",
            "address_2": "ATTENTION: PHARMACY",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053168",
            "telephone_number": "910-256-4159",
            "fax_number": "910-256-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6805 PARKER FARM DR",
            "address_2": "ATTENTION: PHARMACY",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053168",
            "telephone_number": "910-256-4159",
            "fax_number": "910-256-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONISSEN",
        "first_name": "OLATUNBOSUN",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-08",
        "last_updated": "2014-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "15694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLATUNBOSUN",
            "last_name": "ANTONISSEN",
            "middle_name": "OLATOKUNBO",
            "prefix": "MRS.",
            "credential": "RPH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Levi Annas
• Arthur B Annis Jr., DC
• Margie Baum Annis, DC
• Carson Lee Antis, PA-C
• Nadine Marie Antonelli, M.D.
• Micaela Dionysios Antzoulatos, PA-C
• Michael John Apicella, DDS
• Aponi Wellness and Counseling, PLLC
• James E Appel, M.D.
• Colleen Applewhite, RN

• Pharmacist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Pharmacist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.