Provider Demographics
NPI:1033542089
Name:FALOWO, OLAYEMI (RPH)
Entity Type:Individual
Prefix:
First Name:OLAYEMI
Middle Name:
Last Name:FALOWO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:OLAYEMI
Other - Middle Name:
Other - Last Name:FALOWO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:4844 W 28TH LN
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-9815
Mailing Address - Country:US
Mailing Address - Phone:928-502-2464
Mailing Address - Fax:
Practice Address - Street 1:4844 W 28TH LN
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-9815
Practice Address - Country:US
Practice Address - Phone:480-221-3613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS012446183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist