Provider Demographics
NPI:1386362929
Name:OLADELE, OLUFUNMILAYO
Entity type:Individual
Prefix:
First Name:OLUFUNMILAYO
Middle Name:
Last Name:OLADELE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PARLIAMENT RD
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-5670
Mailing Address - Country:US
Mailing Address - Phone:856-725-7583
Mailing Address - Fax:
Practice Address - Street 1:1015 N MAIN RD
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-2538
Practice Address - Country:US
Practice Address - Phone:856-691-1465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03269700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1245313303OtherCVS PHARMACY