Provider Demographics
NPI:1093059222
Name:FILANI, MOSUNMOLA FEYISARA
Entity Type:Individual
Prefix:
First Name:MOSUNMOLA
Middle Name:FEYISARA
Last Name:FILANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 JOHN C CALHOUN DR
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29115-7279
Mailing Address - Country:US
Mailing Address - Phone:803-534-0521
Mailing Address - Fax:803-535-3211
Practice Address - Street 1:1535 JOHN C CALHOUN DR
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29115-7279
Practice Address - Country:US
Practice Address - Phone:803-534-0521
Practice Address - Fax:803-535-3211
Is Sole Proprietor?:No
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11726183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist