Mona Odusola

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

19895 Issued in TX

Legal business name

MONA ODUSOLA

Doing business as

MEDICINE SHOPPE

Practice address

12121 Richmond Ave
Suite 126
Houston, TX 77082-2432

Phone

(281) 558-9433

Fax

(281) 558-9017

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Dena Ferman

Title

Third Party Plan Coordinator

Phone

(314) 993-6000

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• MEDICINE SHOPPE Doing business as

Locations

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1952473753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12121 RICHMOND AVE",
            "address_2": "SUITE 126",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770822432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 RICHMOND AVE",
            "address_2": "SUITE 126",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770822432",
            "telephone_number": "281-558-9433",
            "fax_number": "281-558-9017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONA ODUSOLA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "FERMAN",
        "authorized_official_first_name": "DENA",
        "authorized_official_title_or_position": "THIRD PARTY PLAN COORDINATOR",
        "authorized_official_telephone_number": "314-993-6000"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "19895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "4572194",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144930",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICINE SHOPPE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Moms United ABA LLC
• Mona Mentors Community Agency
• Mona Mentors Community Agency
• Mona Mentors Community Agency, Inc.
• Mona Mentors PLLC
• Natilia Monachino, FNP
• Ashley Monaco, DO
• Thomas Joseph Monaco, MD
• Anne Monahan, CRNA
• Kathleen Monahan

• Community/Retail Pharmacy in Houston, TX
• Providers in Houston, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.