MEDICARE: GWYNOAK 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	333600000X	Pharmacy	P04385	MD
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2132671	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1568551240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GWYNOAK PHARMACY INC

Provider Business Mailing Address
First Line	:	1808 WOODLAWN DR
Second Line	:
City	:	GWYNN OAK
State	:	MD
Zip	:	21207-4023
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1808 WOODLAWN DR
Second Line	:
City	:	GWYNN OAK
State	:	MD
Zip	:	21207-4023
Country	:	US
Telephone Number	:	410-944-6911
Fax Number	:	410-944-6988

Authorized Official
Title or Position	:	OWNER/PHARM
Name	:	SHERIFAT FAKUNLE
Credential	:	RPH
Telephone Number	:	410-944-6911

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	09/11/2025

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Directions to “GWYNOAK PHARMACY INC ” Practice Location

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