Provider Demographics
NPI:1649860677
Name:AJIJO, FOLARIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:FOLARIN
Middle Name:
Last Name:AJIJO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 W MAIN ST STE 105
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-3665
Mailing Address - Country:US
Mailing Address - Phone:972-906-0800
Mailing Address - Fax:
Practice Address - Street 1:560 W MAIN ST STE 105
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3665
Practice Address - Country:US
Practice Address - Phone:972-906-0800
Practice Address - Fax:972-906-0814
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-23
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45278183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist