Active NPI
Omobola Taiwo, RPH
- Pharmacist
- Ellisville, MO
National Provider Identifier
1821110461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2001003742
- Practice address
- 15394 Manchester Rd
Ellisville, MO 63011 - Phone
- (636) 394-6622
- Fax
- (636) 394-9222
- NPI assigned
- Apr 4, 2007
- Sex
- Female
- 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 | 2001003742 | MO | Primary |
Addresses
Primary practice location
15394 Manchester Rd
Ellisville, MO 63011
Mailing address
2480 Town & Country Lane
Town & Country, MO 63131
Phone (314) 809-3183
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2001003742 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fitzpatrick Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Retail Pharmacy
- Ballwin, MO
- NPI 1154425114
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821110461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2480 TOWN & COUNTRY LANE",
"city": "TOWN & COUNTRY",
"state": "MO",
"postal_code": "63131",
"telephone_number": "314-809-3183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15394 MANCHESTER RD",
"city": "ELLISVILLE",
"state": "MO",
"postal_code": "63011",
"telephone_number": "636-394-6622",
"fax_number": "636-394-9222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAIWO",
"first_name": "OMOBOLA",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2001003742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellisville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.