Adeola Adegbohun, PHARM D
Individual provider Active NPI Pharmacist · Baltimore, MD
NPI 1245978147 · NPPES record last updated May 22, 2022
Key facts
- NPI
- 1245978147
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 28559 (MD)
- Practice address
- 601 E 33Rd St
Baltimore, MD 21218-3505 - Phone
- (410) 649-4181
- NPI assigned
- May 22, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28559 | MD | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Giant of Maryland LLC | Past |
Accepting new patients | |
| Giant of Maryland LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 28559 | MD | |
| Pharmacist | 183500000X | 28559 | MD | Yes |
Addresses
Primary practice location
601 E 33Rd St
Baltimore, MD 21218-3505
Mailing address
601 E 33Rd St
Baltimore, MD 21218-3505
Phone (410) 649-4181
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2022. 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.