Healthcare Provider Details

I. General information

NPI: 1750737649
Provider Name (Legal Business Name): BOSONS PHARMACEUTICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2016
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12838 NEW HAMPSHIRE AVE
SILVER SPRING MD
20904-3352
US

IV. Provider business mailing address

12838 NEW HAMPSHIRE AVE
SILVER SPRING MD
20904-3352
US

V. Phone/Fax

Practice location:
  • Phone: 301-622-0744
  • Fax:
Mailing address:
  • Phone: 301-622-0744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberP01948
License Number StateMD

VIII. Authorized Official

Name: REMI OLUFOTEBI
Title or Position: PRESIDENT
Credential:
Phone: 301-622-0744