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Organization

MODSTEL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
OLUTAYO A OLUWABUSI (CHIEF PHARMACIST OWNER)
(301) 937-6662
Entity
Organization

Contact information

Practice address
10820 RHODE ISLAND AVENUE, SUITE F, BELTSVILLE, MD 20705
(301) 937-6662
(301) 595-0947
Mailing address
10820 RHODE ISLAND AVENUE, SUITE F, BELTSVILLE, MD 20705
(301) 937-6662
(301) 595-0947

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
P01780
MD
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2119166
OTHER ID NUMBER-COMMERCIAL NUMBER
05
987474700
MD
Enumeration date
01/30/2007
Last updated
03/07/2023
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  • EDI platform