Provider Demographics
NPI:1700470002
Name:AKINLOSOTU, REBECCA (PHARMD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:AKINLOSOTU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650C WESEL BLVD
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5387
Mailing Address - Country:US
Mailing Address - Phone:301-766-9148
Mailing Address - Fax:
Practice Address - Street 1:1650C WESEL BLVD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5387
Practice Address - Country:US
Practice Address - Phone:301-766-9148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-26
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202217425183500000X
MD26122183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist