Adesola Adekoya, PHARM D
Individual provider Active NPI Pharmacist · Manassas, VA
NPI 1306284526 · NPPES record last updated Jun 10, 2013
Key facts
- NPI
- 1306284526
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202211764 (VA)
- Practice address
- 10836 Clover CT
Manassas, VA 20109-7250 - Phone
- (703) 369-2049
- NPI assigned
- Jun 10, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 0202211764 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202211764 | VA | Yes |
Addresses
Primary practice location
10836 Clover CT
Manassas, VA 20109-7250
Mailing address
10836 Clover Court
Manassas, VA 20109
Other providers in Manassas, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2013. 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.