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Organization

COMFORTIAL HEALTH SYSTEM

Active
Other names
GLORY PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
DR. OLUSEYI BAMIDELE ILORI (PHARMACIST)
(410) 551-0448
Entity
Organization

Contact information

Practice address
3404 EASTERN AVE, BALTIMORE, MD 21224-4121
(410) 551-0448
Mailing address
3404 EASTERN AVE, BALTIMORE, MD 21224-4121
(410) 551-0448

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
16660
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16660
MARYLAND BOARD NUMBER
MD
01
RP441526
PENNSYLVANIA LICENSE NUMBER
PA
Enumeration date
08/18/2017
Last updated
08/18/2017
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