Healthcare Provider Details

I. General information

NPI: 1174004626
Provider Name (Legal Business Name): OLUFUNMI ARIYO PHARMD.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2018
Last Update Date: 08/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 DECATUR ST NW
WASHINGTON DC
20011-4343
US

IV. Provider business mailing address

5711 BALTIMORE AVE APT 101
HYATTSVILLE MD
20781-1670
US

V. Phone/Fax

Practice location:
  • Phone: 202-291-4707
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number0202216087
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: