MEDICARE: DR. ADETAYO BABATUNDE OGUNSANYA 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
1	183500000X	Pharmacist	0202210669	VA
2	183500000X	Pharmacist	PH100001031	DC

General Provider Information

NPI Number	:	1578848024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADETAYO BABATUNDE OGUNSANYA PHARMD

Provider Business Mailing Address
First Line	:	2845 ALABAMA AVE SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-3000
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2845 ALABAMA AVE SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-3000
Country	:	US
Telephone Number	:	202-575-7527
Fax Number	:

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

Provider Enumeration Date	:	10/17/2011
Last Update Date	:	03/04/2014

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