Healthcare Provider Details

I. General information

NPI: 1982281085
Provider Name (Legal Business Name): MEDICINEERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5969 DALLAS PKWY
PLANO TX
75093-7878
US

IV. Provider business mailing address

5969 DALLAS PKWY
PLANO TX
75093-7878
US

V. Phone/Fax

Practice location:
  • Phone: 972-905-4911
  • Fax:
Mailing address:
  • Phone: 972-905-4911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number State

VIII. Authorized Official

Name: DR. KAZIM OLADOTUN OYENUGA
Title or Position: CEO
Credential: RPH, PHD, MSE
Phone: 972-905-4911