Habeeb Asiru-Balogun, PHARM.D.
Individual provider Active NPI Pharmacist · Lithonia, GA
NPI 1013310325 · NPPES record last updated Sep 30, 2014
Key facts
- NPI
- 1013310325
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH027854 (GA)
- Practice address
- 2945 Panola Rd
Lithonia, GA 30038-2313 - Phone
- (770) 322-8486
- NPI assigned
- Sep 30, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH027854 | GA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH027854 | GA | Yes |
Addresses
Primary practice location
2945 Panola Rd
Lithonia, GA 30038-2313
Mailing address
2859 Fairlane Dr
Atlanta, GA 30340-3229
Phone (404) 202-3625
Other providers in Lithonia, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.