Provider Demographics
NPI:1427653062
Name:AKINLEYE, OLUWOLE EMMANUEL (RPH)
Entity type:Individual
Prefix:
First Name:OLUWOLE
Middle Name:EMMANUEL
Last Name:AKINLEYE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:958 SUWANEE BROOK LN
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-4956
Mailing Address - Country:US
Mailing Address - Phone:678-849-8324
Mailing Address - Fax:
Practice Address - Street 1:6327 HIGHWAY 53 E
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-6250
Practice Address - Country:US
Practice Address - Phone:706-216-1303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH022826183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist