Organization
JEBIX CORPORATION
Active
Other names
Mt Olivet Pharmacy & Medical Equipment
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OMOTAYO SULE AWOTUNDE PHARM. D (PHARMACIST)
(202) 529-7001
Entity
Organization
Contact information
Practice address
1809 W VIRGINIA AVE NE, WASHINGTON, DC 20002-1827
(202) 529-7001
(202) 529-7005
Mailing address
1809 W VIRGINIA AVE NE, WASHINGTON, DC 20002-1827
(202) 529-7001
(202) 529-7005
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH3139
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035738300
—
DC
Enumeration date
02/09/2007
Last updated
01/21/2011
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