Organization
ESTENAJ LLC
Active
Other names
PROHEALTH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BUKOLA AJIBADE RPH (PHARMACY MANAGER)
(410) 488-5091
Entity
Organization
Contact information
Practice address
4532 ERDMAN AVE, BALTIMORE, MD 21213-2606
(410) 488-5091
(866) 528-5343
Mailing address
4532 ERDMAN AVE, BALTIMORE, MD 21213-2606
(410) 488-5091
(866) 528-5343
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
16250
MD
3336C0003X
Community/Retail Pharmacy
Primary
16250
MD
3336C0004X
Compounding Pharmacy
16250
MD
3336L0003X
Long Term Care Pharmacy
—
—
Other
Enumeration date
11/08/2010
Last updated
03/15/2022
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