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Organization

GLOJOSELI INC

Active
Other names
OPEN GATE PHARMACY 2
Organization subpart
No

Provider details

NPI number
Authorized official
MOJISOLA OMOBIKE EVBUOMWAN (OWNER)
(706) 662-2400
Entity
Organization

Contact information

Practice address
1807 S LUMPKIN RD STE C, COLUMBUS, GA 31903-2794
(706) 940-0365
(706) 507-5267
Mailing address
2051 10TH AVE, COLUMBUS, GA 31901-1459
(706) 662-2400

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010135
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2151114
PK
Enumeration date
03/31/2015
Last updated
05/07/2015
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