Provider Demographics
NPI:1487020947
Name:ADEBOYE, ADERONKE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ADERONKE
Middle Name:
Last Name:ADEBOYE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 OAKBLUFF DR
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-2934
Mailing Address - Country:US
Mailing Address - Phone:678-558-8584
Mailing Address - Fax:
Practice Address - Street 1:2345 PEACHTREE RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-4147
Practice Address - Country:US
Practice Address - Phone:404-233-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH028696183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist