MEDICARE: OLANREWAJU ABRAHAM LANRE-KOLAWOLE R. PH

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	14624	AZ

General Provider Information

NPI Number	:	1982743019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLANREWAJU ABRAHAM LANRE-KOLAWOLE R. PH

Provider Business Mailing Address
First Line	:	3790 E SEBASTIAN LN
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85297-5247
Country	:	US
Telephone Number	:	520-431-7578
Fax Number	:

Provider Business Practice Location Address
First Line	:	2858 N PINAL AVE
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-7917
Country	:	US
Telephone Number	:	520-426-4701
Fax Number	:

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

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	05/27/2026

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