Healthcare Provider Details

I. General information

NPI: 1336062942
Provider Name (Legal Business Name): ABENA ASANTEWAAH ANKOMAH RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5405 LYNX LN
COLUMBIA MD
21044-2374
US

IV. Provider business mailing address

3426 LITTLELEAF PL
LAUREL MD
20724-1807
US

V. Phone/Fax

Practice location:
  • Phone: 443-537-0026
  • Fax:
Mailing address:
  • Phone: 443-537-0026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number31085
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: