Provider Demographics
NPI:1245983253
Name:YEKU, OLAKUNBI MORENIKE (RPH)
Entity type:Individual
Prefix:
First Name:OLAKUNBI
Middle Name:MORENIKE
Last Name:YEKU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6904 HALLECK ST
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-2318
Mailing Address - Country:US
Mailing Address - Phone:516-395-6029
Mailing Address - Fax:
Practice Address - Street 1:11100 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-2120
Practice Address - Country:US
Practice Address - Phone:301-572-9681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28399183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist