Provider Demographics
NPI:1972840825
Name:ESHO, ADEWALE A (BPHARM)
Entity Type:Individual
Prefix:MR
First Name:ADEWALE
Middle Name:A
Last Name:ESHO
Suffix:
Gender:M
Credentials:BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3507 BAKER RD NW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-3706
Mailing Address - Country:US
Mailing Address - Phone:770-917-0218
Mailing Address - Fax:770-529-1916
Practice Address - Street 1:3507 BAKER RD NW
Practice Address - Street 2:SUITE 300
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-3706
Practice Address - Country:US
Practice Address - Phone:770-917-0218
Practice Address - Fax:770-529-1916
Is Sole Proprietor?:No
Enumeration Date:2013-01-12
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH022981183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist