MEDICARE: ADEBAYO ADENIRAN PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RP446107	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124399480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADEBAYO ADENIRAN PHARM.D.

Provider Business Mailing Address
First Line	:	4835 WOODLAND AVE # 1
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-4433
Country	:	US
Telephone Number	:	215-883-0568
Fax Number	:

Provider Business Practice Location Address
First Line	:	4835 WOODLAND AVE # 1
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-4433
Country	:	US
Telephone Number	:	215-883-0568
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2012
Last Update Date	:	02/05/2025

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