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NPI Code Detail

MEDICARE: URENNA JERRYALAGBAOSO PHARMD

MEDICARE: URENNA JERRYALAGBAOSO PHARMD
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
11835P1200XPharmacotherapy PharmacistRP454573PA

General Provider Information

NPI Number : 1457202863
Entity Type Code : Individual
Provider Name (Legal Business Name) : URENNA JERRYALAGBAOSO PHARMD
Provider Business Mailing Address
First Line : 1120 WINTERMEAD LOOP
Second Line :
City : SALISBURY
State : MD
Zip : 21801-2595
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : PO BOX 211699
Second Line :
City : EAGAN
State : MN
Zip : 55121-3699
Country : US
Telephone Number : 800-338-6833
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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