MEDICARE: HEALTHPOINTE PHARMACY

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	3336C0003X	Community/Retail Pharmacy
2	333600000X	Pharmacy	P07174	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2162117	OTHER		PK

General Provider Information

NPI Number	:	1154788024
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHPOINTE PHARMACY

Provider Business Mailing Address
First Line	:	9203 OXON HILL RD
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-4834
Country	:	US
Telephone Number	:	240-350-8207
Fax Number	:

Provider Business Practice Location Address
First Line	:	9203 OXON HILL RD
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-4834
Country	:	US
Telephone Number	:	240-493-8792
Fax Number	:	855-755-2356

Authorized Official
Title or Position	:	CO-OWNER/PHARMACIST
Name	:	OLADAPO ALLI
Credential	:
Telephone Number	:	240-350-8207

Provider Enumeration Date	:	01/24/2016
Last Update Date	:	03/15/2017

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