Provider Demographics
NPI:1972976975
Name:ORIOKE, OLUFUNSO AYODELE
Entity type:Individual
Prefix:
First Name:OLUFUNSO
Middle Name:AYODELE
Last Name:ORIOKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1457 N ELISEO FELIX JR WAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-1509
Mailing Address - Country:US
Mailing Address - Phone:323-542-7773
Mailing Address - Fax:
Practice Address - Street 1:1457 N ELISEO FELIX JR WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-1509
Practice Address - Country:US
Practice Address - Phone:323-542-7773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies