Individual provider Active NPI

Olufunmilayo Rebecca Agunbiade, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Temple Hills, MD
National Provider Identifier
1235592569
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
21781 Issued in MD
Practice address
6104 Old Branch Ave
Temple Hills, MD 20748-2518
Phone
(301) 702-6100
NPI assigned
Apr 4, 2016
Last updated
Apr 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 21781 MD Primary

Addresses

Primary practice location

6104 Old Branch Ave
Temple Hills, MD 20748-2518

Mailing address

3412 Carriage Walk CT
Laurel, MD 20724-1916
Phone (240) 478-0099

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
21781MDMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1235592569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3412 CARRIAGE WALK CT",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207241916",
            "telephone_number": "240-478-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6104 OLD BRANCH AVE",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207482518",
            "telephone_number": "301-702-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUNBIADE",
        "first_name": "OLUFUNMILAYO",
        "middle_name": "REBECCA",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-04",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MD",
            "license": "21781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Hills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.