Organization
SHA DIABETES CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAI BOLAJI PHARM.D, MBA/MHCA (DR./CEO)
(334) 778-7090
Entity
Organization
Contact information
Practice address
172 LUDS WAY, DOTHAN, AL 36304-8803
(334) 475-0646
(334) 888-8445
Mailing address
172 LUDS WAY,, P. O. BOX 8803, DOTHAN, AL 36304-8803
(334) 778-7090
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/10/2023
Last updated
01/12/2024
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