Provider Demographics
NPI:1366286163
Name:ALAYOKU, BOSUN (PHARMD, RPH, MSMCT)
Entity type:Individual
Prefix:DR
First Name:BOSUN
Middle Name:
Last Name:ALAYOKU
Suffix:
Gender:M
Credentials:PHARMD, RPH, MSMCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23208 FRONT BEACH RD
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32413-1012
Mailing Address - Country:US
Mailing Address - Phone:850-230-1434
Mailing Address - Fax:
Practice Address - Street 1:23208 FRONT BEACH RD
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32413-1012
Practice Address - Country:US
Practice Address - Phone:850-230-1434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS67080183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist