Provider Demographics
NPI:1255652848
Name:ONAYEMI, ADEYEMI O (RPH)
Entity Type:Individual
Prefix:MR
First Name:ADEYEMI
Middle Name:O
Last Name:ONAYEMI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 PEARL STREET
Mailing Address - Street 2:PHARMERICA
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301
Mailing Address - Country:US
Mailing Address - Phone:800-242-0978
Mailing Address - Fax:800-345-7741
Practice Address - Street 1:1123 PEARL STREET
Practice Address - Street 2:PHARMERICA
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301
Practice Address - Country:US
Practice Address - Phone:800-242-0978
Practice Address - Fax:800-345-7741
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist