Healthcare Provider Details

I. General information

NPI: 1023296449
Provider Name (Legal Business Name): DRG PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 08/16/2021
Certification Date: 08/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N LOMBARD ST STE A
OXNARD CA
93030-8032
US

IV. Provider business mailing address

401 N LOMBARD ST STE A
OXNARD CA
93030-8032
US

V. Phone/Fax

Practice location:
  • Phone: 805-488-8200
  • Fax: 805-488-8211
Mailing address:
  • Phone: 805-488-8200
  • Fax: 805-488-8211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number53764
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY T WHITE
Title or Position: CEO/OWNER
Credential:
Phone: 805-981-1171