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General NPI Number Information
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NPI Number | 1457662876
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Entity Type | Organization
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Legal Business Name | AJIJO INC
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 560 W MAIN ST STE 105
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City | LEWISVILLE
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State | TX
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Zip | 75057-3629
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Country | US
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Telephone | 972-906-0800
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Fax | 972-906-0814
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Provider Business Mailing Address
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Address Line | 560 W MAIN ST STE 105
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City | LEWISVILLE
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State | TX
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Zip | 75057-3665
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Country | US
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Telephone | 972-906-0900
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Fax | 972-906-0814
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY SERVICES
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Name | DR. FOLARIN AJIJO
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Credential | PHARMD
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Telephone | 972-906-0814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 26992
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License Number State | TX
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