Individual
OLA BIDEX OGUNDIYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD, RPH
Contact information
Practice address
3555 GREENWOOD RD, SHREVEPORT, LA 71109
(318) 525-0144
(318) 525-0222
Mailing address
1733 S REUNION DR, SHREVEPORT, LA 71118-2250
(773) 708-2305
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.022417
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64472
PHAMD, RPH
TX
01
—
PST.022417
PHARMACIST
LA
Enumeration date
03/27/2018
Last updated
04/19/2019
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