Healthcare Provider Details

I. General information

NPI: 1972888261
Provider Name (Legal Business Name): ROLLING OAKS HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2011
Last Update Date: 10/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 E. ROLLING OAKS DR. SUITE 140
THOUSAND OAKS CA
91361-1077
US

IV. Provider business mailing address

325 E. ROLLING OAKS DR. SUITE 140
THOUSAND OAKS CA
91361-1077
US

V. Phone/Fax

Practice location:
  • Phone: 866-311-1006
  • Fax: 888-236-7171
Mailing address:
  • Phone: 866-311-1006
  • Fax: 888-236-7171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY46918
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPHY46918
License Number StateCA

VIII. Authorized Official

Name: MS. AMAL H ZEIN
Title or Position: PRESIDENT/CEO
Credential: RPH MHA
Phone: 805-557-1006