Provider Demographics
NPI:1083335467
Name:LEWIS, OLUWA KEMI ADEDAYO ADEYEMI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:OLUWA KEMI
Middle Name:ADEDAYO ADEYEMI
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 FOXTON LN APT 201
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-2867
Mailing Address - Country:US
Mailing Address - Phone:765-714-4380
Mailing Address - Fax:
Practice Address - Street 1:3010 FOXTON LN APT 201
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-2867
Practice Address - Country:US
Practice Address - Phone:765-714-4380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029955A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist