MEDICARE: OLNEY PROFESSIONAL PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy
2	3336C0004X	Compounding Pharmacy
3	333600000X	Pharmacy
4	3336C0003X	Community/Retail Pharmacy	P04031	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	2037816	OTHER	PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053404491
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLNEY PROFESSIONAL PHARMACY INC

Provider Business Mailing Address
First Line	:	18111 PRINCE PHILIP DR
Second Line	:	SUITE 100
City	:	OLNEY
State	:	MD
Zip	:	20832-1513
Country	:	US
Telephone Number	:	301-774-9812
Fax Number	:	301-774-9813

Provider Business Practice Location Address
First Line	:	18111 PRINCE PHILIP DR STE 100
Second Line	:
City	:	OLNEY
State	:	MD
Zip	:	20832-1503
Country	:	US
Telephone Number	:	301-774-9812
Fax Number	:	301-774-9813

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HELEN YI
Credential	:	RPH
Telephone Number	:	301-774-9812

Provider Enumeration Date	:	09/30/2006
Last Update Date	:	04/17/2026

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Directions to “OLNEY PROFESSIONAL PHARMACY INC ” Practice Location

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