Individual provider Active NPI

Adigun Olatubosun Itabiyi, RPH

  • Pharmacist
  • Abington, PA
National Provider Identifier
1639537939
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP450324 Issued in PA
Practice address
1111 Highland Ave
Abington, PA 19001-3703
Phone
(347) 898-1413
NPI assigned
Feb 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP450324 PA Primary

Addresses

Primary practice location

1111 Highland Ave
Abington, PA 19001-3703

Mailing address

1111 Highland Ave
Abington, PA 19001-3703
Phone (347) 898-1413

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)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RP450324PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Victoria Memorial Healthcare, LLC CurrentSince May 1, 2024 Accepting new patients
Olive Tree Healthcare LLC Current Accepting new patients
Olive Tree Healthcare LLC PastSince Oct 5, 2021 Accepting new patients

Organizations & group practices 3

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": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1639537939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 HIGHLAND AVE",
            "city": "ABINGTON",
            "state": "PA",
            "postal_code": "190013703",
            "telephone_number": "347-898-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 HIGHLAND AVE",
            "city": "ABINGTON",
            "state": "PA",
            "postal_code": "190013703",
            "telephone_number": "347-898-1413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITABIYI",
        "first_name": "ADIGUN",
        "middle_name": "OLATUBOSUN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-02",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP450324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abington, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.