Olusegun Adesesan Bamgbelu, PHARM D

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

PH60776370 Issued in WA

Practice address

Memorial Cornerstone Pharmacy
4003 Creekside Loop
Yakima, WA 98908

Phone

(509) 248-3263

Fax

(509) 575-8700

NPI assigned

Nov 15, 2019

Last updated

Nov 15, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1255976056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 TIETON DRIVE",
            "address_2": "PHARMACY DEPARTMENT",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989028036",
            "telephone_number": "509-575-8036",
            "fax_number": "509-575-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEMORIAL CORNERSTONE PHARMACY",
            "address_2": "4003 CREEKSIDE LOOP",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "98908",
            "telephone_number": "509-248-3263",
            "fax_number": "509-575-8700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2811 Tieton Drive",
            "address_2": "Pharmacy Department",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "98902",
            "country_code": "US",
            "telephone_number": "509-575-8036 x8036",
            "fax_number": "509-575-8700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAMGBELU",
        "first_name": "OLUSEGUN",
        "middle_name": "ADESESAN",
        "name_prefix": "Mr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-15",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "WA",
            "license": "PH60776370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENCE",
            "identifier": "PH60776370",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jashanpreet S Ballagan, MD
• Angelo Anthony Ballasiotes, PHARM.D.
• Kylee Brooke Ballingham-Biles, LMP
• Christopher David Balm, ATC
• Chuck Leevan Figueras Baluca
• Claire Elizabeth Bange, MS, CF-SLP
• Goldy Bansal, MD
• America Barajas
• Jaime Barajas, CP61586797
• Victoria Barajas, CG70031211

• Ambulatory Care Pharmacist in Yakima, WA
• Providers in Yakima, WA by specialty
• Ambulatory Care Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2019; 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.