Provider Demographics
NPI:1174994370
Name:BAKARE, OLAJIDE BRANDON (PHARMD)
Entity type:Individual
Prefix:
First Name:OLAJIDE
Middle Name:BRANDON
Last Name:BAKARE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1680 ONEAL LN APT 123
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-1624
Mailing Address - Country:US
Mailing Address - Phone:225-939-0925
Mailing Address - Fax:
Practice Address - Street 1:730 S RANGE AVE
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-4401
Practice Address - Country:US
Practice Address - Phone:225-664-9452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.021337183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist