Taiwo Aigberua, PHARMD
Individual provider Active NPI Pharmacist · Fayetteville, GA
NPI 1720535537 · NPPES record last updated Sep 9, 2016
Key facts
- NPI
- 1720535537
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH028292 (GA)
- Practice address
- 11860 Plantation Pkwy
Fayetteville, GA 30215-8048 - Phone
- (404) 933-7812
- NPI assigned
- Sep 9, 2016
- 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 |
|---|---|---|---|
| RPH028292 | GA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH028292 | GA | Yes |
Addresses
Primary practice location
11860 Plantation Pkwy
Fayetteville, GA 30215-8048
Mailing address
11860 Plantation Pkwy
Fayetteville, GA 30215-8048
Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2016. 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.