Provider Demographics
NPI:1053610675
Name:AKINFOLAJIMI, MOBOLUWAJI (RPH)
Entity type:Individual
Prefix:MR
First Name:MOBOLUWAJI
Middle Name:
Last Name:AKINFOLAJIMI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9414 BROAD MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-3102
Mailing Address - Country:US
Mailing Address - Phone:804-935-0999
Mailing Address - Fax:804-935-0999
Practice Address - Street 1:9414 BROAD MEADOWS RD
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-3102
Practice Address - Country:US
Practice Address - Phone:804-935-0999
Practice Address - Fax:804-935-0999
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012343183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0202012343OtherVIRGINIA PHARMACIST LICENCE