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General NPI Number Information
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NPI Number | 1619584281
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Entity Type | Individual
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Provider Name | TOSIN A ADELAKUN PHARMD.
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Gender | Male
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Dates
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Enumeration Date | 09/28/2020
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Last Update Date | 09/28/2020
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Provider Practice Location Address
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Address Line | 4500 12TH STREET EXT
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City | WEST COLUMBIA
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State | SC
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Zip | 29172-3025
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Country | US
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Telephone | 803-462-5005
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Fax |
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Provider Business Mailing Address
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Address Line | 315 BLEEKER LN
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-2457
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Country | US
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Telephone | 678-308-7492
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 42330
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License Number State | SC
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