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General NPI Number Information
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NPI Number | 1992406292
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Entity Type | Organization
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Legal Business Name | EDENRX PHARMACY LLC
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Dates
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Enumeration Date | 03/14/2023
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 3819 HARBOR RD UNIT 104
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City | CHESAPEAKE BEACH
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State | MD
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Zip | 20732-3110
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Country | US
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Telephone | 443-906-3336
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Fax | 443-964-5938
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Provider Business Mailing Address
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Address Line | 3819 HARBOR RD UNIT 104
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City | CHESAPEAKE BEACH
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State | MD
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Zip | 20732-3110
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Country | US
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Telephone | 443-906-3336
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Fax | 443-964-5938
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | DR. TOLULOPE DEHINBO
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Credential | PHARM.D
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Telephone | 907-444-5833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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