Organization Active NPI

Naylor Lane Pharmacy Inc.

Doing business as Wellcare Pharmacy

  • Pharmacist
  • Pikesville, MD
National Provider Identifier
1982009510
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
Legal business name
NAYLOR LANE PHARMACY INC.
Doing business as
Wellcare Pharmacy
Practice address
4000 Old Court Rd
Suite 101
Pikesville, MD 21208-2800
Phone
(410) 484-2105
Fax
(410) 484-2106
NPI assigned
Oct 24, 2014
Last updated
Oct 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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

Authorized official

Name
Dr. Temitope GbolagunNPI 1649368796
Title
Pharmacist
Phone
(410) 484-2105

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X Primary

Addresses

Primary practice location

4000 Old Court Rd
Suite 101
Pikesville, MD 21208-2800

Mailing address

4000 Old Court Rd
Suite 101
Pikesville, MD 21208-2800
Phone (410) 484-2105

Other names 1

  • Wellcare Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210406000534 MD Part B Supplier - Pharmacy 7416364666 Practice locations: Pikesville, MD

National Provider Directory

National Provider Directory

Locations

4000 Old Court Rd
Ste 101
Pikesville, MD 21208
Phone (410) 484-2105

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1982009510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 OLD COURT RD",
            "address_2": "SUITE 101",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212082800",
            "telephone_number": "410-484-2105",
            "fax_number": "410-484-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 OLD COURT RD",
            "address_2": "SUITE 101",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212082800",
            "telephone_number": "410-484-2105",
            "fax_number": "410-484-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAYLOR LANE PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "GBOLAGUN",
        "authorized_official_first_name": "TEMITOPE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "410-484-2105",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellcare Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pikesville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.