Provider Demographics
NPI:1659592418
Name:IBRAHIM, KHADIJAT OLUWAWEMIMO (PHARM TECH)
Entity Type:Individual
Prefix:MRS
First Name:KHADIJAT
Middle Name:OLUWAWEMIMO
Last Name:IBRAHIM
Suffix:
Gender:F
Credentials:PHARM TECH
Other - Prefix:MISS
Other - First Name:KHADIJAT
Other - Middle Name:
Other - Last Name:LAWAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BPHARM
Mailing Address - Street 1:13908 BRIARWOOD DRIVE #2123,
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708
Mailing Address - Country:US
Mailing Address - Phone:240-432-3772
Mailing Address - Fax:240-280-2172
Practice Address - Street 1:NEIGHBORCARE PHARMACY SERVICES, 9036 JUNCTION DRIVE
Practice Address - Street 2:ANNAPOLIS JUNCTION, MD
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20701-1152
Practice Address - Country:US
Practice Address - Phone:240-568-4324
Practice Address - Fax:301-497-9042
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician