Active NPI
Farooq Adetola
- Pharmacist
- Centreville, MD
National Provider Identifier
1760930432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 24407
- Practice address
- 2440 Centreville Rd
Centreville, MD 21617-2802 - Phone
- (443) 262-9640
- NPI assigned
- Sep 12, 2016
- Last updated
- Sep 30, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 24407 | MD | Primary |
Addresses
Primary practice location
2440 Centreville Rd
Centreville, MD 21617-2802
Mailing address
10800 Clipper Cir
Princess Anne, MD 21853-4318
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24407 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475193600000",
"number": "1760930432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10800 CLIPPER CIR",
"city": "PRINCESS ANNE",
"state": "MD",
"postal_code": "218534318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2440 CENTREVILLE RD",
"city": "CENTREVILLE",
"state": "MD",
"postal_code": "216172802",
"telephone_number": "443-262-9640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADETOLA",
"first_name": "FAROOQ",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-12",
"last_updated": "2016-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "24407",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centreville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.