Healthcare Provider Details

I. General information

NPI: 1023419017
Provider Name (Legal Business Name): MAUREEN C OGBONNA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2014
Last Update Date: 08/31/2025
Certification Date: 08/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6721 CHESAPEAKE CENTER DR
GLEN BURNIE MD
21060-6572
US

IV. Provider business mailing address

8229 HICKORY HOLLOW DR
GLEN BURNIE MD
21060-8721
US

V. Phone/Fax

Practice location:
  • Phone: 410-863-1285
  • Fax: 410-863-1287
Mailing address:
  • Phone: 214-395-6891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number22245
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: