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WAVERLY PROFESSIONAL PHARMACY
NPI 1194760520
Pharmacy - Community/Retail Pharmacy in Baltimore, MD

Active since June 19, 2006
453 E 28TH ST, BALTIMORE, MD 21218(410) 467-4471(410) 467-4553 Get Directions Write a Review

NPPES record last updated: March 11, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Waverly Professional Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WAVERLY PROFESSIONAL PHARMACY (NPI 1194760520) is a healthcare organization registered as a community/retail pharmacy in Baltimore, Maryland and active in the NPI registry since June 2006. The organization lists Adesola Hakeem Otubanjo, Pic, as its authorized official.

NPPES Registry Identity

NPI1194760520
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameTHE PAVILION CORPORATION
Location Address453 E 28TH STBaltimore, MD 21218-4426
Mailing Address453 E 28th StBaltimore, MD 21218-4426 · (410) 467-4471 · Fax (410) 467-4553
Phone(410) 467-4471
Fax(410) 467-4553
Organization SubpartNo
Authorized OfficialAdesola Hakeem OtubanjoPic · (410) 467-4471
Enumeration DateJune 19, 2006
Last NPPES UpdateMarch 11, 2010
✔ NPI 1194760520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in MD · P02225
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
Also ListedPharmacy · Compounding PharmacyTaxonomy 3336C0004X
453 E 28TH ST, Baltimore, MD 21218
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Other Names 1

Doing Business AsWaverly Professional Pharmacy

Other Identifiers 3

Other2122404Other Id Number
Medicaid014402900MD
Medicare NSC1231380001

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is The Pavilion Corporation's NPI number?

The NPI number for The Pavilion Corporation is 1194760520. It was assigned to this organization in the NPPES registry on June 19, 2006. The provider is doing business as Waverly Professional Pharmacy.

Where is The Pavilion Corporation located?

The Pavilion Corporation is located at 453 E 28th St, Baltimore, MD 21218. The listed phone number is (410) 467-4471.

What is The Pavilion Corporation's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

What insurance does The Pavilion Corporation accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 48 other insurers list The Pavilion Corporation as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for The Pavilion Corporation was last updated on March 11, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.