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General NPI Number Information
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NPI Number | 1124393137
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Entity Type | Organization
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Legal Business Name | AJIJO VENTURES DBA HEALTHPRO PHARMACY
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Dates
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Enumeration Date | 03/09/2012
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Last Update Date | 03/09/2012
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Provider Practice Location Address
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Address Line | 800 N BISHOP AVE STE 4
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City | DALLAS
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State | TX
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Zip | 75208-4203
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Country | US
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Telephone | 214-942-4000
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Fax | 214-942-4004
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Provider Business Mailing Address
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Address Line | 800 N BISHOP AVE STE 4
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City | DALLAS
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State | TX
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Zip | 75208-4203
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Country | US
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Telephone | 214-942-4000
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Fax | 214-942-4004
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Authorized Official
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Title or Position | OWNER
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Name | DR. FOLARIN OLUWOLE AJIJO
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Credential |
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Telephone | 248-231-5045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 27935
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License Number State | TX
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