Active NPI
Omishola Adeyemo
- Pharmacist
- Lithonia, GA
National Provider Identifier
1700559598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH018481
- Practice address
- 2415 Dekalb Medical Pkwy Ste B
Lithonia, GA 30058-4929 - Phone
- (770) 837-9034
- NPI assigned
- Jul 27, 2021
- Last updated
- Jul 27, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH018481 | GA | Primary |
Addresses
Primary practice location
2415 Dekalb Medical Pkwy Ste B
Lithonia, GA 30058-4929
Mailing address
PO Box 301
Redan, GA 30074-0301
Phone (770) 837-9034
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH018481 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Royal Style Inc. | Current | Accepting new patients |
Locations
2415 DeKalb Medical Pkwy
Ste B
Lithonia, GA 30058
Phone (770) 837-9034
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627344000000",
"number": "1700559598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 301",
"city": "REDAN",
"state": "GA",
"postal_code": "300740301",
"telephone_number": "770-837-9034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2415 DEKALB MEDICAL PKWY STE B",
"city": "LITHONIA",
"state": "GA",
"postal_code": "300584929",
"telephone_number": "770-837-9034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADEYEMO",
"first_name": "OMISHOLA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-27",
"last_updated": "2021-07-27",
"certification_date": "2021-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH018481",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lithonia, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.