Provider Demographics
NPI:1225537483
Name:FAIRPRICEMD INC
Entity Type:Organization
Organization Name:FAIRPRICEMD INC
Other - Org Name:FAIRPRICELABS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OLUJIMI
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUWOLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-366-9614
Mailing Address - Street 1:6175 HICKORY FLAT HWY STE 110-411
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-7207
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6175 HICKORY FLAT HWY STE 110-411
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-7207
Practice Address - Country:US
Practice Address - Phone:888-845-2283
Practice Address - Fax:678-880-9149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory