Provider Demographics
NPI:1851690606
Name:OLADEJI, OLADOTUN O (RPH)
Entity Type:Individual
Prefix:
First Name:OLADOTUN
Middle Name:O
Last Name:OLADEJI
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 1:1065 CHANDLER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-8136
Mailing Address - Country:US
Mailing Address - Phone:678-637-7876
Mailing Address - Fax:
Practice Address - Street 1:3549 CHAMBLEE TUCKER RD
Practice Address - Street 2:
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-4409
Practice Address - Country:US
Practice Address - Phone:770-455-8620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH021886183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist