Individual provider Active NPI

Moronke Obaro

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Edgewater, MD
National Provider Identifier
1316247786
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
18676 Issued in MD
Practice address
52 Central Ave W
Edgewater, MD 21037-2622
Phone
(410) 919-1160
Fax
(410) 919-1161
NPI assigned
Nov 1, 2010
Last updated
Apr 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18676 MD
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 18676 MD Primary

Addresses

Primary practice location

52 Central Ave W
Edgewater, MD 21037-2622

Mailing address

52 Central Ave W
Edgewater, MD 21037-2622
Phone (410) 919-1160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Undefined Non-Physician Type (Specify)
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1053 State Route 3 N
Suite 4
Gambrills, MD 21054-1781

2680 Evergreen Rd
Odenton, MD 21113-2311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18676MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Health Solutions LLC Pharmacist Clinician (PHC)/ Clinical Pharmacy Specialist CurrentSince Jan 1, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1316247786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 CENTRAL AVE W",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210372622",
            "telephone_number": "410-919-1160",
            "fax_number": "410-919-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 CENTRAL AVE W",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210372622",
            "telephone_number": "410-919-1160",
            "fax_number": "410-919-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBARO",
        "first_name": "MORONKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-01",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "18676",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MD",
            "license": "18676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewater, MD

Sources for this page

Verify at the official NPI Registry.