Omotayo Julieanne Aborisade, RPH
Individual provider Active NPI Pharmacist · Pineville, WV
NPI 1225337652 · NPPES record last updated Mar 24, 2011
Key facts
- NPI
- 1225337652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RP0007592 (WV)
- Practice address
- Route 10, Main Strret
Pineville, WV 24874 - Phone
- (304) 732-8886
- NPI assigned
- Mar 24, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| RP0007592 | WV | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP0007592 | WV | Yes |
Addresses
Primary practice location
Route 10, Main Strret
Pineville, WV 24874
Mailing address
683 Cranberry Dr
Mount Hope, WV 25880-9165
Other providers in Pineville, WV
- Danielle Myree Acord
- Frankie Lynn Adkins
- Demia Aliff Osborne
- Appalachian Highway Medical & Surgical Clinic, PLLC
- Bonny Lou Arias
All providers in Pineville, WV · Pharmacist in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2011. 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.