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General NPI Number Information
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NPI Number | 1144964784
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Entity Type | Organization
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Legal Business Name | SELAM PHARMACY LLC
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Dates
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Enumeration Date | 04/20/2022
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Last Update Date | 05/16/2022
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Provider Practice Location Address
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Address Line | 2447 TELEGRAPH AVE
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City | OAKLAND
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State | CA
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Zip | 94612-2404
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Country | US
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Telephone | 510-984-1429
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Fax | 510-646-9840
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Provider Business Mailing Address
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Address Line | 2447 TELEGRAPH AVE
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City | OAKLAND
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State | CA
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Zip | 94612-2404
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Country | US
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Telephone | 510-984-1429
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Fax | 510-646-9840
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Authorized Official
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Title or Position | PHARMACIST-IN-CHARGE
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Name | DR. MICHAEL ABRAHAM GEBRU
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Credential | DOCTOR OF PHARMACY
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Telephone | 510-984-1429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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