Provider Demographics
NPI:1376859645
Name:ADEMIJU, ADETOUN O (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:ADETOUN
Middle Name:O
Last Name:ADEMIJU
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 JONES STATION RD W
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-4200
Mailing Address - Country:US
Mailing Address - Phone:410-647-0451
Mailing Address - Fax:410-647-1624
Practice Address - Street 1:25 JONES STATION RD W
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-4200
Practice Address - Country:US
Practice Address - Phone:410-647-0451
Practice Address - Fax:410-647-1624
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19063183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist