Olutoyin Ezekiel Makinde, RPH

Individual provider Active NPI Pharmacist · Forest Hill, TX

NPI 1336801059 · NPPES record last updated Oct 11, 2021

Key facts

NPI
1336801059
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
68487 (TX)
Practice address
3145 Mansfield Hwy
Forest Hill, TX 76119-5938
Phone
(817) 535-1182
Fax
(817) 534-4089
NPI assigned
Oct 11, 2021
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
68487TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Pharmacy Inc Past
since Oct 17, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 68487 TX Yes

Addresses

Primary practice location

3145 Mansfield Hwy
Forest Hill, TX 76119-5938

Mailing address

623 Teresa LN
Grand Prairie, TX 75052-2816
Phone (682) 251-5689

Other providers in Forest Hill, TX

All providers in Forest Hill, TX · Pharmacist in Texas

Sources for this page

Verify at the official NPI Registry.