Healthcare Provider Details

I. General information

NPI: 1154312551
Provider Name (Legal Business Name): DYNAMEDIC DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 30TH ST
OAKLAND CA
94609-3303
US

IV. Provider business mailing address

411 30TH ST
OAKLAND CA
94609-3303
US

V. Phone/Fax

Practice location:
  • Phone: 510-834-3100
  • Fax: 510-834-2988
Mailing address:
  • Phone: 510-834-3100
  • Fax: 510-834-2988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPHY47437
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY47437
License Number StateCA

VIII. Authorized Official

Name: MR. LARRY T BUI
Title or Position: PRESIDENT
Credential:
Phone: 510-839-7900