Provider Demographics
NPI:1770874802
Name:AKINDELE, OLUGBENGA (B PHARM)
Entity type:Individual
Prefix:
First Name:OLUGBENGA
Middle Name:
Last Name:AKINDELE
Suffix:
Gender:M
Credentials:B PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3424 STONY FARM DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-1667
Mailing Address - Country:US
Mailing Address - Phone:502-384-5635
Mailing Address - Fax:
Practice Address - Street 1:4721 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-2654
Practice Address - Country:US
Practice Address - Phone:503-447-6550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-23
Last Update Date:2011-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY013942183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist