NPIMap

Organization Active NPI

Pharmacy & Pharmaceutical Services Provider

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Bowie, MD
National Provider Identifier
1619378890
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
13780 Issued in MD
Legal business name
PHARMACY & PHARMACEUTICAL SERVICES PROVIDER
Practice address
13202 Steeplechase Dr
Bowie, MD 20715-4542
Phone
(301) 352-2514
Fax
(301) 805-0664
NPI assigned
Sep 8, 2014
Last updated
Dec 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Authorized official

Name
Mr. Felix F Etebom, BS BSPHARMNPI 1376863183
Title
President,Ceo & Owner
Phone
(301) 352-2514

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 9

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 13780 MD
Specialist 174400000X 13780 MD
Research Study Specialist 1744R1102X 13780 MD
Pharmacist 183500000X 13780 MD
Nutrition Support Pharmacist 1835N1003X 13780 MD
Pharmacotherapy Pharmacist 1835P1200X 13780 MD
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 13780 MD Primary
Geriatric Pharmacist 1835G0303X 13780 MD
Health Educator 174H00000X 13780 MD

Addresses

Primary practice location

13202 Steeplechase Dr
Bowie, MD 20715-4542

Mailing address

13202 Steeplechase Dr
Bowie, MD 20715-4542
Phone (301) 352-2514

Other identifiers 1

IdentifierTypeStateIssuer
URLOtherWWW.PHARMACYPHARMACEUTICALSERVICES.COM

Other names 1

  • PPSP LLC Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670457600000",
    "number": "1619378890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13202 STEEPLECHASE DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154542",
            "telephone_number": "301-352-2514",
            "fax_number": "301-805-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13202 STEEPLECHASE DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154542",
            "telephone_number": "301-352-2514",
            "fax_number": "301-805-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY & PHARMACEUTICAL SERVICES PROVIDER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-08",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A",
        "authorized_official_last_name": "ETEBOM",
        "authorized_official_first_name": "FELIX",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT,CEO & OWNER",
        "authorized_official_telephone_number": "301-352-2514",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS BSPHARM"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "MD",
            "license": "13780",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "13780",
            "primary": false
        },
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": "MD",
            "license": "13780",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "13780",
            "primary": false
        },
        {
            "code": "1835N1003X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nutrition Support",
            "state": "MD",
            "license": "13780",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "MD",
            "license": "13780",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MD",
            "license": "13780",
            "primary": true
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "MD",
            "license": "13780",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "MD",
            "license": "13780",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WWW.PHARMACYPHARMACEUTICALSERVICES.COM",
            "identifier": "URL",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PPSP LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "PPSP LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.