Comfortial Health System

Primary specialty

PharmacyTaxonomy code 333600000X

License

16660 Issued in MD

Legal business name

COMFORTIAL HEALTH SYSTEM

Doing business as

Glory Pharmacy

Practice address

3404 Eastern Ave
Baltimore, MD 21224-4121

Phone

(410) 551-0448

NPI assigned

Aug 18, 2017

Last updated

Aug 18, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Oluseyi Bamidele Ilori

Title

Pharmacist

Phone

(410) 551-0448

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• GLORY PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503014400000",
    "number": "1801312038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3404 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212244121",
            "telephone_number": "410-551-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3404 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212244121",
            "telephone_number": "410-551-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORTIAL HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-18",
        "last_updated": "2017-08-18",
        "status": "A",
        "authorized_official_last_name": "ILORI",
        "authorized_official_first_name": "OLUSEYI",
        "authorized_official_middle_name": "BAMIDELE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "410-551-0448",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MD",
            "license": "16660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA LICENSE NUMBER",
            "identifier": "RP441526",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND BOARD NUMBER",
            "identifier": "16660",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLORY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Pharmacy in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2017; 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.