Provider Demographics
NPI:1346587045
Name:OLAGBENDE, OLAWALE OKEOWO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:OLAWALE
Middle Name:OKEOWO
Last Name:OLAGBENDE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 THORNTON RD
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-1574
Mailing Address - Country:US
Mailing Address - Phone:678-945-1640
Mailing Address - Fax:678-945-1640
Practice Address - Street 1:3030 HEADLAND DR SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30311-5439
Practice Address - Country:US
Practice Address - Phone:404-346-1423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026768183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist