Healthcare Provider Details

I. General information

NPI: 1962258772
Provider Name (Legal Business Name): LINDA ADA OPARA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2024
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

914 JENNINGS MILL DR
BOWIE MD
20721-6223
US

IV. Provider business mailing address

914 JENNINGS MILL DR
BOWIE MD
20721-6223
US

V. Phone/Fax

Practice location:
  • Phone: 347-377-2540
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28114
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: