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General NPI Number Information
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NPI Number | 1851843502
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Entity Type | Individual
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Provider Name | KENNETH AGBOIFO PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/28/2016
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Last Update Date | 10/28/2016
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Provider Practice Location Address
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Address Line | 1838 GREENE TREE RD STE 100
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City | PIKESVILLE
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State | MD
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Zip | 21208-6391
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Country | US
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Telephone | 410-486-8106
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Fax |
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Provider Business Mailing Address
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Address Line | 9912 CERVIDAE LN APT 103
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-1928
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Country | US
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Telephone | 443-413-1338
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 52233
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License Number State | MD
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