MEDICARE: DR. OLAWALE OKEOWO OLAGBENDE PHARMD

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	RPH026768	GA

General Provider Information

NPI Number	:	1346587045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OLAWALE OKEOWO OLAGBENDE PHARMD

Provider Business Mailing Address
First Line	:	590 THORNTON RD
Second Line	:
City	:	LITHIA SPRINGS
State	:	GA
Zip	:	30122-1574
Country	:	US
Telephone Number	:	678-945-1640
Fax Number	:	678-945-1640

Provider Business Practice Location Address
First Line	:	3030 HEADLAND DR SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30311-5439
Country	:	US
Telephone Number	:	404-346-1423
Fax Number	:

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

Provider Enumeration Date	:	01/15/2013
Last Update Date	:	02/27/2023

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Directions to “ DR. OLAWALE OKEOWO OLAGBENDE PHARMD” Practice Location

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