Active NPI
Omotayo Lasean Olowolayemo, PHARMACIST
- Pharmacist
- Bladensburg, MD
National Provider Identifier
1821648866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26683
- Practice address
- 5403A Annapolis Rd
Bladensburg, MD 20710-2201 - Phone
- (301) 277-7107
- NPI assigned
- Sep 11, 2019
- 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 | 26683 | MD | Primary |
Addresses
Primary practice location
5403A Annapolis Rd
Bladensburg, MD 20710-2201
Mailing address
4506 Valiant Trce
Bowie, MD 20720-4678
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 |
|---|---|---|---|
| 26683 | MD | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568160000000",
"number": "1821648866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4506 VALIANT TRCE",
"city": "BOWIE",
"state": "MD",
"postal_code": "207204678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5403A ANNAPOLIS RD",
"city": "BLADENSBURG",
"state": "MD",
"postal_code": "207102201",
"telephone_number": "301-277-7107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLOWOLAYEMO",
"first_name": "OMOTAYO",
"middle_name": "LASEAN",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-11",
"last_updated": "2019-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "26683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bladensburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.