Provider Demographics
NPI:1972949444
Name:COLE, OMOLOLA T (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:OMOLOLA
Middle Name:T
Last Name:COLE
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 1:3800 PRINCETON LAKES PKWY SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-5580
Mailing Address - Country:US
Mailing Address - Phone:404-344-5158
Mailing Address - Fax:
Practice Address - Street 1:3800 PRINCETON LAKES PKWY SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-5580
Practice Address - Country:US
Practice Address - Phone:404-344-5158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-10
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025568183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist