=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790219400
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | YOU FIRST PHARMACY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/19/2017
-----------------------------------------------------
Last Update Date | 01/05/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 507A EASTERN BLVD
-----------------------------------------------------
City | ESSEX
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21221-6702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-969-2967
-----------------------------------------------------
Fax | 443-559-5089
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1614 LINDLEY DR
-----------------------------------------------------
City | HANOVER
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21076-1228
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-969-2967
-----------------------------------------------------
Fax | 443-559-5089
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BUSINESS OWNER
-----------------------------------------------------
Name | MR. OLA OLADIPUPO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 301-704-1673
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------