Christiana Olamide Adegboye, PHARMD
Individual provider Active NPI Pharmacist · Tomah, WI
NPI 1982203188 · NPPES record last updated Oct 20, 2020
Key facts
- NPI
- 1982203188
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 18276-40 (WI)
- Practice address
- 222 W McCoy Blvd
Tomah, WI 54660-3291 - Phone
- (608) 372-7557
- NPI assigned
- Oct 20, 2020
- Sex
- Female
- 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 |
|---|---|---|---|
| 18276-40 | WI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18276-40 | WI | Yes |
Addresses
Primary practice location
222 W McCoy Blvd
Tomah, WI 54660-3291
Mailing address
1502 East Ave N
Onalaska, WI 54650-7003
Other providers in Tomah, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2020. 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.