Healthcare Provider Details

I. General information

NPI: 1376859645
Provider Name (Legal Business Name): ADETOUN ADEMIJU PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2010
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 KIRK AVE
BALTIMORE MD
21218-5507
US

IV. Provider business mailing address

2400 KIRK AVE
BALTIMORE MD
21218-5507
US

V. Phone/Fax

Practice location:
  • Phone: 410-383-8300
  • Fax: 410-383-3160
Mailing address:
  • Phone: 410-383-8300
  • Fax: 410-383-3160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19063
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: