Provider Demographics
NPI:1699431700
Name:OMITOWOJU, OREOLUWA (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:OREOLUWA
Middle Name:
Last Name:OMITOWOJU
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5073 BROOKHILL LN
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45807-8417
Mailing Address - Country:US
Mailing Address - Phone:567-204-6123
Mailing Address - Fax:
Practice Address - Street 1:5073 BROOKHILL LN
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45807-8417
Practice Address - Country:US
Practice Address - Phone:567-204-6123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03441270183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist