Provider Demographics
NPI:1174688972
Name:AKINTUNDE, OLAIDE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:OLAIDE
Middle Name:
Last Name:AKINTUNDE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:OLAIDE
Other - Middle Name:
Other - Last Name:AKINMADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2817 REILLY ST
Mailing Address - Street 2:
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28310-7324
Mailing Address - Country:US
Mailing Address - Phone:910-907-2575
Mailing Address - Fax:910-907-9606
Practice Address - Street 1:5-4257 BASTONGE STREET
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-7324
Practice Address - Country:US
Practice Address - Phone:910-907-2575
Practice Address - Fax:910-907-9606
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15542183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist