Healthcare Provider Details

I. General information

NPI: 1255251633
Provider Name (Legal Business Name): URBANA PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3420 WORTHINGTON BLVD STE B
FREDERICK MD
21704-7020
US

IV. Provider business mailing address

3420 WORTHINGTON BLVD STE B
FREDERICK MD
21704-7020
US

V. Phone/Fax

Practice location:
  • Phone: 240-831-5155
  • Fax: 301-810-2940
Mailing address:
  • Phone: 240-831-5155
  • Fax: 301-810-2940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number State

VIII. Authorized Official

Name: ADETOLA OLUFUNMILAYO DARAMOLA
Title or Position: OWNER/PIC
Credential: PHARM.D
Phone: 240-831-5155