Provider Demographics
NPI:1801587811
Name:BELAIR PHARMACY LLC
Entity type:Organization
Organization Name:BELAIR PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:BUKOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:AJIBADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-601-3136
Mailing Address - Street 1:5309 BELAIR RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-5109
Mailing Address - Country:US
Mailing Address - Phone:410-601-3136
Mailing Address - Fax:
Practice Address - Street 1:5309 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-5109
Practice Address - Country:US
Practice Address - Phone:410-601-3136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy