NPIMap

Organization Active NPI

East Pines Pharmacy LLC

  • Durable Medical Equipment & Medical Supplies
  • Riverdale, MD
National Provider Identifier
1255904579
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
EAST PINES PHARMACY LLC
Practice address
6003 66TH Ave Ste 102
Riverdale, MD 20737-1780
Phone
(301) 459-6211
Fax
(301) 459-6217
NPI assigned
Jul 23, 2021
Organization subpart
Yes
Parent organization
EAST PINES PHARMACY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Authorized official

Name
Dr. Omotayo S Awotunde, R.PHNPI 1275643496
Title
President/Ceo
Phone
(301) 459-6211

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

6003 66TH Ave Ste 102
Riverdale, MD 20737-1780

Mailing address

6003 66TH Ave Ste 102
Riverdale, MD 20737-1780
Phone (301) 459-6211

Other names 1

  • East Pines Pharmacy & Medical Equipment Doing business as

National Provider Directory

National Provider Directory
Tax ID family
East Pines Pharmacy LLC2 organizations share this tax ID, including this one
Part of
East Pines Pharmacy LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6003 66th Ave
Ste 102
Riverdale, MD 20737
Phone (301) 459-6211

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1255904579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6003 66TH AVE STE 102",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371780",
            "telephone_number": "301-459-6211",
            "fax_number": "301-459-6217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6003 66TH AVE STE 102",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371780",
            "telephone_number": "301-459-6211",
            "fax_number": "301-459-6217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST PINES PHARMACY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST PINES PHARMACY LLC",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "AWOTUNDE",
        "authorized_official_first_name": "OMOTAYO",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "301-459-6211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Pines Pharmacy & Medical Equipment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverdale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.