Provider Demographics
NPI:1972780468
Name:OLUWA, OMOYELE ARET (PHARMD)
Entity type:Individual
Prefix:DR
First Name:OMOYELE
Middle Name:ARET
Last Name:OLUWA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6236 HOLLY SPRING PKWY
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188
Mailing Address - Country:US
Mailing Address - Phone:770-928-5536
Mailing Address - Fax:770-928-5541
Practice Address - Street 1:6236 HOLLY SPRING PKWY
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-6501
Practice Address - Country:US
Practice Address - Phone:770-928-5536
Practice Address - Fax:770-928-5541
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH022182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist