Provider Demographics
NPI:1184133878
Name:PRICE, DAMILOLA ALADE (PHARMD)
Entity type:Individual
Prefix:
First Name:DAMILOLA
Middle Name:ALADE
Last Name:PRICE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:DAMILOLA
Other - Middle Name:FOLAKE
Other - Last Name:ALADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2909 CHANCERY LN
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-4346
Mailing Address - Country:US
Mailing Address - Phone:917-282-6263
Mailing Address - Fax:
Practice Address - Street 1:6000 W HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32512
Practice Address - Country:US
Practice Address - Phone:850-505-6819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-25
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS574761835G0303X
MD216221835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
1184133878OtherNPI ENUMERATOR