Healthcare Provider Details

I. General information

NPI: 1396118261
Provider Name (Legal Business Name): THREE OAKS PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2015
Last Update Date: 03/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

861 COX CREEK PARKWAY
FLORENCE AL
35630
US

IV. Provider business mailing address

861 COX CREEK PARKWAY
FLORENCE AL
35630
US

V. Phone/Fax

Practice location:
  • Phone: 256-764-4675
  • Fax: 256-764-3675
Mailing address:
  • Phone: 256-764-4675
  • Fax: 256-764-3675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number114534
License Number StateAL

VIII. Authorized Official

Name: VALERIE OAKLEY
Title or Position: OWNER/PHARMACIST
Credential:
Phone: 256-764-4675