PHARMACY & PHARMACEUTICAL SERVICES PROVIDER (NPI# 1619378890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619378890 |
| Entity Type | Organization |
| Organization Name | PHARMACY & PHARMACEUTICAL SERVICES PROVIDER |
| Other Organization Name | PPSP LLC |
| Practice Address |
13202 Steeplechase Dr Bowie MD 20715-4542 |
| Mailing Address |
Po Box 51 Greenbelt MD 20768-0051 |
| Practice Telephone | 3013522514 |
| Practice Fax Number | 3018050664 |
| Mailing Telephone | 3013522514 |
| Mailing Fax Number | 3018050664 |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2019-09-25 |
| Authorized Official Name | MR. FELIX F ETEBOM (PRESIDENT,CEO & OWNER) |
| Authorized Official Telephone | 3013522514 |
| Authorized Official Credential | BS BSPHARM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 13780 | MD | Other Service Providers |
| N | 1744R1102X |
Specialist Specialization: Research Study |
13780 | MD | Other Service Providers |
| N | 171W00000X | Contractor | 13780 | MD | Other Service Providers |
| N | 183500000X | Pharmacist | 13780 | MD | Pharmacy Service Providers |
| N | 174H00000X | Health Educator | 13780 | MD | Other Service Providers |
| N | 1835G0303X |
Pharmacist Specialization: Geriatric |
13780 | MD | Pharmacy Service Providers |
| N | 1835N1003X |
Pharmacist Specialization: Nutrition Support |
13780 | MD | Pharmacy Service Providers |
| N | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
13780 | MD | Pharmacy Service Providers |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
13780 | MD | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WWW.PHARMACYPHARMACEUTICALSERVICES.COM | URL | 01 |
| Other Name | Type Code |
|---|---|
| PPSP LLC | Other Name - Individual/Organization |
| Street Address |
13202 STEEPLECHASE DR |
| City | BOWIE |
| State | MD |
| Zip Code | 20715-4542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376863183 | Felix F. Etebom | Pharmacist | 13202 Steeplechase Dr, Bowie, MD 20715-4542 | 2010-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104304757 | Aynia V Dorsey | Occupational Therapist | 6915 Laurel Bowie Rd Ste 205b, Bowie, MD 20715 | 2018-08-04 |
| 1558852988 | Dmv Foot and Ankle Center | Podiatrist | 15480 Annapolis Rd Ste 202-437, Bowie, MD 20715 | 2018-05-22 |
| 1861918435 | Ryan Leigh Brown | Psychologist | 3231 Superior Lane, Suite, A6, Bowie, MD 20715 | 2017-08-16 |
| 1073060430 | Chinwendu Ezeoru | Nurse Practitioner | 13004 Viewpoint Ln, Bowie, MD 20715 | 2016-09-02 |
| 1386094977 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 15501 Annapolis Rd, Suite 400, Bowie, MD 20715 | 2016-06-15 |
| 1083003164 | Megan Elizabeth Cooper | Social Worker | 2812 Bosworth Ln, Bowie, MD 20715 | 2015-01-13 |
| 1467856740 | Nathan-todd Consulting | Community/Behavioral Health | 3231 Superior Court Lane,# A5, Bowie, MD 20715 | 2014-10-15 |
| 1841534468 | Varsity Professional Rehabilitation and Staffing, LLC | Physical Therapist | 14000 Jericho Park Road, Bowie, MD 20715 | 2012-11-20 |
| 1013269893 | Felix Chukwudi Ohams | Registered Nurse | 7613 Old Chapel Dr, Bowie, MD 20715 | 2012-10-04 |
| 1720336464 | Tara Marie Hatfield | Physical Therapist | 100 Whitemarsh Park Drive, Bowie, MD 20715 | 2012-08-28 |
| Find all providers in zip 20715 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922594837 | Adebayo Ajifolokun | Pharmacist | 2307 Clerklee Way, Bowie, MD 20721-1866 | 2018-07-03 |
| 1982968921 | Adaeze Ifeoma Ezebuiro | Pharmacist | 2508 Huntley Ct, Bowie, MD 20721-2983 | 2012-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720697436 | Maxcare Pharmacy | Pharmacist | 7448 Baltimore Annapolis Blvd Ste A, Glen Burnie, MD 21061-3468 | 2020-07-28 |
| 1255966735 | David Lee Lowery | Pharmacist | 1102 Midvale Ave, Mount Airy, MD 21771-5522 | 2020-03-05 |
| 1639703523 | Mary Katherine Emadi | Pharmacist | 1320 Londontown Blvd, Eldersburg, MD 21784-6409 | 2020-02-28 |
| 1245878875 | Crowns Pharmacy LLC | Pharmacist | 9705 Fort Meade Rd, Laurel, MD 20707-4405 | 2019-12-13 |
| 1932750536 | Oluwadamilola Ademiluyi | Pharmacist | 202 Bottsford Ave, Upper Marlboro, MD 20774-8416 | 2019-09-25 |
| 1093361008 | Mark Adjetey | Pharmacist | 18924 Marsh Hawk Ln, Gaithersburg, MD 20879-1774 | 2019-08-15 |
| 1841760048 | Roudabeh Faghri | Pharmacist | 1201 Dutchmans Creek Dr, Brunswick, MD 21716-9770 | 2018-11-29 |
| 1003384678 | Prime Clinical Associates, LLC | Pharmacist | 9019 Sunni Shade Ct, Perry Hall, MD 21128-9222 | 2018-11-12 |
| 1669993606 | Maria Giannas | Pharmacist | 6510 O'donnell St, Baltimore, MD 21224 | 2017-06-29 |
| 1396272928 | Min S Kwon | Pharmacist | 14347 Musgrove Farm Ct, Glenwood, MD 21738-9535 | 2017-05-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.