Healthcare Provider Details

I. General information

NPI: 1427679125
Provider Name (Legal Business Name): OLUWAKEMI ADEMOSU PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 05/04/2020
Certification Date: 05/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 W WARM SPRINGS RD UNIT 614
HENDERSON NV
89014-3515
US

IV. Provider business mailing address

1575 W WARM SPRINGS RD UNIT 614
HENDERSON NV
89014-3515
US

V. Phone/Fax

Practice location:
  • Phone: 443-627-0352
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number19922
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: