Active NPI
Omolola Folasade Pefok
- Pharmacist
- Pasadena, MD
National Provider Identifier
1851045975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16169
- Practice address
- 3400 Mountain Rd
Pasadena, MD 21122-2021 - Phone
- (410) 360-1509
- NPI assigned
- Feb 8, 2022
- 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 | 16169 | MD | Primary |
Addresses
Primary practice location
3400 Mountain Rd
Pasadena, MD 21122-2021
Mailing address
13319 Landsdales Hope Way
Bowie, MD 20720-6381
Phone (301) 455-1844
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 |
|---|---|---|---|
| 16169 | MD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dynamic Ventures Holdings | Current | Accepting new patients | |
| Columbia Health Care, LLC | Current | Accepting new patients |
Organizations & group practices 2
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.
-
- Pharmacy
- Columbia, MD
- NPI 1376810846
-
- Primary Care Clinic/Center
- Columbia, MD
- NPI 1538531215
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644278400000",
"number": "1851045975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13319 LANDSDALES HOPE WAY",
"city": "BOWIE",
"state": "MD",
"postal_code": "207206381",
"telephone_number": "301-455-1844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 MOUNTAIN RD",
"city": "PASADENA",
"state": "MD",
"postal_code": "211222021",
"telephone_number": "410-360-1509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEFOK",
"first_name": "OMOLOLA",
"middle_name": "FOLASADE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-08",
"last_updated": "2022-02-08",
"certification_date": "2022-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "16169",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.