Provider Demographics
NPI:1376810846
Name:DYNAMIC VENTURES HOLDINGS
Entity Type:Organization
Organization Name:DYNAMIC VENTURES HOLDINGS
Other - Org Name:DYNAMIC CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:OMOLOLA
Authorized Official - Middle Name:FOLASADE
Authorized Official - Last Name:PEFOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-455-1494
Mailing Address - Street 1:7120 MINSTREL WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5248
Mailing Address - Country:US
Mailing Address - Phone:410-290-3903
Mailing Address - Fax:240-206-3762
Practice Address - Street 1:7120 MINSTREL WAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5248
Practice Address - Country:US
Practice Address - Phone:410-290-3903
Practice Address - Fax:240-206-3762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy