Provider Demographics
NPI:1821604109
Name:AYANJOKE, EMMANUEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:
Last Name:AYANJOKE
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 1:4023 HOLLYHOCK LN
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-9240
Mailing Address - Country:US
Mailing Address - Phone:141-934-4439
Mailing Address - Fax:
Practice Address - Street 1:1130 W 3RD ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-6812
Practice Address - Country:US
Practice Address - Phone:937-225-9350
Practice Address - Fax:937-225-9355
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03440097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist