Provider Demographics
NPI:1639577190
Name:FAITH PHARMACY LLC
Entity Type:Organization
Organization Name:FAITH PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ADEKUNLE
Authorized Official - Middle Name:O
Authorized Official - Last Name:ONALAJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-290-4453
Mailing Address - Street 1:7915 HARFORD RD
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-5815
Mailing Address - Country:US
Mailing Address - Phone:443-290-4553
Mailing Address - Fax:443-290-4557
Practice Address - Street 1:7915 HARFORD RD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-5815
Practice Address - Country:US
Practice Address - Phone:443-290-4553
Practice Address - Fax:443-290-4557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18593333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD333600000XOtherPHARMACY