Healthcare Provider Details

I. General information

NPI: 1790227049
Provider Name (Legal Business Name): FRANK ODAME PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2016
Last Update Date: 11/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3110 OLNEY SANDY SPRING RD
OLNEY MD
20832-1408
US

IV. Provider business mailing address

1 CVS DR
WOONSOCKET RI
02895-6146
US

V. Phone/Fax

Practice location:
  • Phone: 301-774-6155
  • Fax:
Mailing address:
  • Phone: 800-746-7287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number20223
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number0202210802
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: