Provider Demographics
NPI:1588935761
Name:CEDAR ROAD PHARMACY
Entity type:Organization
Organization Name:CEDAR ROAD PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ADEFUNKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEYINKA-OJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-686-2287
Mailing Address - Street 1:945 COUNTRY CLUB BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-8089
Mailing Address - Country:US
Mailing Address - Phone:757-686-2287
Mailing Address - Fax:
Practice Address - Street 1:945 COUNTRY CLUB BLVD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-8089
Practice Address - Country:US
Practice Address - Phone:757-686-2287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy