Provider Demographics
NPI:1447721253
Name:LANGLEY PARK PHARMACY & MEDICAL SUPPLIES LLC
Entity type:Organization
Organization Name:LANGLEY PARK PHARMACY & MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABIODUN
Authorized Official - Middle Name:AYODEJI
Authorized Official - Last Name:AREWA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:301-844-5280
Mailing Address - Street 1:8112 HOLLY MANOR WAY
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-9611
Mailing Address - Country:US
Mailing Address - Phone:301-957-8080
Mailing Address - Fax:301-557-9786
Practice Address - Street 1:8004 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-4611
Practice Address - Country:US
Practice Address - Phone:301-844-5280
Practice Address - Fax:301-557-9786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-06
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy