MEDICARE: OLUWATOSIN UMOEKA

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	42500	TX

General Provider Information

NPI Number	:	1396076246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLUWATOSIN UMOEKA

Provider Business Mailing Address
First Line	:	4504 MORNING GLORY TRL
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-4242
Country	:	US
Telephone Number	:	952-457-3613
Fax Number	:	817-466-2999

Provider Business Practice Location Address
First Line	:	4504 MORNING GLORY TRL
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-4242
Country	:	US
Telephone Number	:	952-457-3613
Fax Number	:	817-466-2999

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

Provider Enumeration Date	:	01/15/2010
Last Update Date	:	09/08/2010

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Directions to “ OLUWATOSIN UMOEKA ” Practice Location

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