MEDICARE: DR. GANIAT OLUWAMAYOWA OJEABULU 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	SP40758	FL
2	183500000X	Pharmacist	49832	TX

General Provider Information

NPI Number	:	1669759908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GANIAT OLUWAMAYOWA OJEABULU PHARMD

Provider Business Mailing Address
First Line	:	4001 ROCKS POINT PL
Second Line	:
City	:	RIVIERA BEACH
State	:	FL
Zip	:	33407-1103
Country	:	US
Telephone Number	:	786-877-9297
Fax Number	:

Provider Business Practice Location Address
First Line	:	4001 ROCKS POINT PL
Second Line	:
City	:	RIVIERA BEACH
State	:	FL
Zip	:	33407-1103
Country	:	US
Telephone Number	:	786-877-9297
Fax Number	:

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

Provider Enumeration Date	:	11/15/2011
Last Update Date	:	11/15/2011

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