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General NPI Number Information
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NPI Number | 1922621077
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Entity Type | Individual
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Provider Name | MUYIBAT BOLATITO OSENI
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Gender | Female
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Dates
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Enumeration Date | 05/24/2020
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Last Update Date | 05/24/2020
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Provider Practice Location Address
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Address Line | 896 HIGHWAY 81 E
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City | MCDONOUGH
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State | GA
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Zip | 30252-2914
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Country | US
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Telephone | 770-914-7748
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Fax |
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Provider Business Mailing Address
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Address Line | 9801 PRESWICKE PT
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City | ALPHARETTA
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State | GA
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Zip | 30022-8682
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Country | US
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Telephone | 770-866-1855
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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 | 030744
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License Number State | GA
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