=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619614351
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | OLUWATOYIN GENEVIEVE FADIPE PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2022
-----------------------------------------------------
Last Update Date | 07/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1874 PIEDMONT AVE NE STE 100A
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30324-4816
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-733-6800
-----------------------------------------------------
Fax | 404-733-6880
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4108 DUNWOODY GABLES DR
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30338-6949
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-302-5402
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RPH035692
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------