Provider Demographics
NPI:1992803118
Name:ADEKOYA, PRINCE AYODELE JR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PRINCE
Middle Name:AYODELE
Last Name:ADEKOYA
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16806 SLEEPY SPRING CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3501
Mailing Address - Country:US
Mailing Address - Phone:240-731-3766
Mailing Address - Fax:301-277-7127
Practice Address - Street 1:5403 ANNAPOLIS RD
Practice Address - Street 2:
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-2201
Practice Address - Country:US
Practice Address - Phone:301-277-7107
Practice Address - Fax:301-277-7127
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD155971835G0303X, 1835P0018X, 1835P2201X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD15597OtherLICENSE NUMBER
MD15597OtherPHARMACY LICENSE NUMBER