NPI 1003114166

Oluwole T Taiwo

Practitioner Pharmacist Mableton, GA

Practice location

Address: 4637 Hicks Rd SW, Mableton, GA 30126-1333
Phone: (770) 819-9177
Fax: (770) 739-7732

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence RPH023040 (GA)

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Registry record

NPI: 1003114166
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Mar 2011
Record last updated: 14 Mar 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.