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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