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General NPI Number Information
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NPI Number | 1922804632
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Entity Type | Individual
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Provider Name | OLUGBEMI DICKSON AKINLOSOTU
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Gender | Male
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Dates
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Enumeration Date | 02/22/2025
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 17 DIVISION ST
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City | WAITE PARK
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State | MN
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Zip | 56387-1349
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Country | US
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Telephone | 320-203-1035
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Fax |
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Provider Business Mailing Address
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Address Line | 1525 24TH AVE N APT 13
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City | SAINT CLOUD
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State | MN
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Zip | 56303-1314
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Country | US
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Telephone | 431-373-3070
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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 | 126774
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License Number State | MN
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