Individual provider Active NPI

Ejike Izundu Unegbu, PHARM.D

  • Geriatric Pharmacist
  • Laurel, MD
National Provider Identifier
1619260650
Registry record updated Oct 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric PharmacistTaxonomy code 1835G0303X
License
14315 Issued in MD
Practice address
7350 Van Dusen Rd
Suite 120
Laurel, MD 20707-5263
Phone
(301) 604-8500
Fax
(301) 604-8887
NPI assigned
May 24, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Pharmacist 1835G0303X 14315 MD Primary

Addresses

Primary practice location

7350 Van Dusen Rd
Suite 120
Laurel, MD 20707-5263

Mailing address

7350 Van Dusen Rd
Suite 120
Laurel, MD 20707-5263
Phone (301) 604-8500

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)
Enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
14315MDMDGeriatric Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lmcrx LTC Current Accepting new patients
Laurel Pharmacy II LLC Current Accepting new patients
Laurel Medical Center Pharmacy Inc Current Accepting new patients
Medaccess Pharmacy SVC LLC PastSince Nov 5, 2004 Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728691200000",
    "number": "1619260650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7350 VAN DUSEN RD",
            "address_2": "SUITE 120",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075263",
            "telephone_number": "301-604-8500",
            "fax_number": "301-604-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 VAN DUSEN RD",
            "address_2": "SUITE 120",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075263",
            "telephone_number": "301-604-8500",
            "fax_number": "301-604-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNEGBU",
        "first_name": "EJIKE",
        "middle_name": "IZUNDU",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-24",
        "last_updated": "2024-10-12",
        "certification_date": "2024-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "MD",
            "license": "14315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2024; 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.