MEDICARE: ABRAHAM FOLORUNSO OJO

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	183500000X	Pharmacist	16093	MD

General Provider Information

NPI Number	:	1629218672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABRAHAM FOLORUNSO OJO

Provider Business Mailing Address
First Line	:	4380 PARK HEIGHTS AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-6737
Country	:	US
Telephone Number	:	410-664-8644
Fax Number	:	410-542-6471

Provider Business Practice Location Address
First Line	:	4380 PARK HEIGHTS AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-6737
Country	:	US
Telephone Number	:	410-664-8644
Fax Number	:	410-542-6471

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2009
Last Update Date	:	03/04/2009

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