DR. DEREK FOMBA (NPI# 1952710220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952710220 |
| Entity Type | Individual |
| Full Name | DR. DEREK FOMBA |
| Practice Address |
7401 Annapolis Rd Hyattsville MD 20784-2313 |
| Practice Telephone | 3015777282 |
| Practice Fax Number | 3015775024 |
| Mailing Telephone | 3015777282 |
| Mailing Fax Number | 3015775024 |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2014-08-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 19842 | MD | Pharmacy Service Providers |
| Street Address |
7401 ANNAPOLIS RD |
| City | HYATTSVILLE |
| State | MD |
| Zip Code | 20784-2313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831731363 | Detos Services LLC | Ambulance | 7609 Fontainebleau Drive, #2213, New Carrollton, MD 20784 | 2019-10-16 |
| 1649742263 | Nelson Ngang | Registered Nurse | 6611 Stanton Road, Hyattsville, MD 20784 | 2018-12-20 |
| 1497222152 | Relindis Lum Asangong | Home Health Aide | 5393 Quincy Street, Hyattville, MD 20784 | 2018-10-30 |
| 1801378278 | Reward Oruomachukwu Ezeogu Sr. | Home Health Aide | 3410 55th Avenue Apt 403, Hyattsville, MD 20784 | 2018-09-03 |
| 1417439118 | Lesly Teke Agwenjang | Home Health Aide | 5201 Quincy Street, Apt B2, Blandesburg, MD 20784 | 2018-08-30 |
| 1457839003 | Oluwafunbi Olafusi | Home Health Aide | 5337 85th Ave Apt 13, New Carrollton, MD 20784 | 2018-08-04 |
| 1427542000 | Richard Earl Ballard Jr. | Counselor | Site Office: Charles Carroll Ms 6130 Lamont Drive, C/o Ms. Claudia B.-walter, Fbcog- Ceo for Son Rise Cc&i, New Carrollton, MD 20784 | 2018-06-18 |
| 1225530272 | Tamba Biango | Home Health Aide | 4066 Warner Ave C5, Hyattsville, MD 20784 | 2018-03-06 |
| 1356867410 | Boris Acha Acha | Home Health Aide | 3512 54th Avenue, Hyattsville, MD 20784 | 2017-08-20 |
| 1144744707 | Patient First Maryland Medical Group Pllc | Non-Pharmacy Dispensing Site | 6201 Annapolis Road, Landover Hills, MD 20784 | 2017-07-26 |
| Find all providers in zip 20784 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689136822 | Vivian Kila Berinyuy-james | Pharmacist | 6495 New Hampshire Ave Ste B130, Hyattsville, MD 20783-3245 | 2019-04-05 |
| 1538645783 | Azuka Nwude | Pharmacist | 3350 Toledo Ter, Hyattsville, MD 20782-4105 | 2018-07-11 |
| 1508315326 | Brittney Lowe | Pharmacist | 7225 24th Pl, Hyattsville, MD 20783-2717 | 2016-09-22 |
| 1649638453 | Krista Hein | Pharmacist | 3702 East West Highway, Hyattsville, MD 20782 | 2016-02-08 |
| 1093183048 | Gobezie Tarefe | Pharmacist | 7408 Annapolis Rd, Hyattsville, MD 20784-2314 | 2015-09-08 |
| 1275918484 | Michael Edward Williams IIi | Pharmacist | 3300 E West Hwy Apt 456, Hyattsville, MD 20782-2184 | 2015-07-29 |
| 1649671074 | Hayatte Koulamallah | Pharmacist | 660 Stretford Way Apt 210, Hyattsville, MD 20785-5950 | 2014-09-04 |
| 1154738441 | Tiana Holmes | Pharmacist | 7041 Martin Luther King Jr Hwy, Hyattsville, MD 20785-4016 | 2014-07-18 |
| 1093072852 | Ndunganoh G Asogo | Pharmacist | 2709 Nicholson St, Apt 203, Hyattsville, MD 20782-2811 | 2012-04-18 |
| 1396015665 | Malford Norman Buster Jr. | Pharmacist | 1001 Chillum Rd Apt 120, Hyattsville, MD 20782-2213 | 2012-01-04 |
| Find all providers in HYATTSVILLE | ||||
| City | HYATTSVILLE |
| Zip Code | 20784 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.