MEDICARE: DR. YEMISI VIVIAN OBEMBE PHARMD, MBA.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	18631	MD

General Provider Information

NPI Number	:	1356744148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YEMISI VIVIAN OBEMBE PHARMD, MBA.

Provider Business Mailing Address
First Line	:	1290 E WEST HWY
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-3242
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1290 E WEST HWY
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-3242
Country	:	US
Telephone Number	:	301-588-6261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2014
Last Update Date	:	01/08/2015

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