Provider Demographics
NPI:1982219424
Name:ALABI, ABIOLA B
Entity Type:Individual
Prefix:
First Name:ABIOLA
Middle Name:B
Last Name:ALABI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 VINEWOOD LN N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55442-1734
Mailing Address - Country:US
Mailing Address - Phone:763-553-9731
Mailing Address - Fax:763-553-9144
Practice Address - Street 1:4005 VINEWOOD LN N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55442-1734
Practice Address - Country:US
Practice Address - Phone:763-553-9731
Practice Address - Fax:763-553-9144
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN122191183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist