Provider Demographics
NPI:1780260851
Name:ADEJARE, ADEKUNLE OLADIMEJI (PHARMD)
Entity type:Individual
Prefix:
First Name:ADEKUNLE
Middle Name:OLADIMEJI
Last Name:ADEJARE
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 1:2791 S DELSEA DR
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-7079
Mailing Address - Country:US
Mailing Address - Phone:856-405-0962
Mailing Address - Fax:
Practice Address - Street 1:2791 S DELSEA DR
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-7079
Practice Address - Country:US
Practice Address - Phone:856-405-0962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04160400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist