MEDICARE: OAKLAND PARK PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	021334000	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2078713	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124143037
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAKLAND PARK PHARMACY

Provider Business Mailing Address
First Line	:	1486 OAKLAND PARK AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-3507
Country	:	US
Telephone Number	:	614-262-8719
Fax Number	:	614-262-8975

Provider Business Practice Location Address
First Line	:	1486 OAKLAND PARK AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-3507
Country	:	US
Telephone Number	:	614-262-8719
Fax Number	:	614-262-8975

Authorized Official
Title or Position	:	PRES
Name	:	BACHVAN CAO
Credential	:	RPH
Telephone Number	:	614-262-8719

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	03/02/2016

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Directions to “OAKLAND PARK PHARMACY ” Practice Location

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