Healthcare Provider Details

I. General information

NPI: 1093649626
Provider Name (Legal Business Name): OLAPEJU GRACE ADERINWALE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

594 SIGMAN RD NE STE 200
CONYERS GA
30013-1365
US

IV. Provider business mailing address

1153 OVERVIEW DR
LAWRENCEVILLE GA
30044-6269
US

V. Phone/Fax

Practice location:
  • Phone: 404-922-9812
  • Fax: 800-755-1483
Mailing address:
  • Phone: 678-789-2991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH025761
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: