Provider Demographics
NPI:1205616786
Name:SHOLEYE, OLUFUNKEJI ADERONKE (PHARM D)
Entity type:Individual
Prefix:
First Name:OLUFUNKEJI
Middle Name:ADERONKE
Last Name:SHOLEYE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 MONTEAGLE TRCE
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-4912
Mailing Address - Country:US
Mailing Address - Phone:770-401-0764
Mailing Address - Fax:
Practice Address - Street 1:5095 PEACHTREE PKWY
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-2524
Practice Address - Country:US
Practice Address - Phone:770-209-9299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0185151835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care