Provider Demographics
NPI:1427384049
Name:KARGBO, OSMAN
Entity type:Individual
Prefix:MR
First Name:OSMAN
Middle Name:
Last Name:KARGBO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14121 RIVERBIRCH CT
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-9484
Mailing Address - Country:US
Mailing Address - Phone:301-317-3394
Mailing Address - Fax:
Practice Address - Street 1:14121 RIVERBIRCH CT
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-9484
Practice Address - Country:US
Practice Address - Phone:301-317-3394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-02
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDK621667027445183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist