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General NPI Number Information
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NPI Number | 1154312551
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Entity Type | Organization
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Legal Business Name | DYNAMEDIC DRUGS INC
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Dates
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Enumeration Date | 11/03/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 411 30TH ST
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City | OAKLAND
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State | CA
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Zip | 94609-3303
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Country | US
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Telephone | 510-834-3100
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Fax | 510-834-2988
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Provider Business Mailing Address
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Address Line | 411 30TH ST
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City | OAKLAND
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State | CA
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Zip | 94609-3303
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Country | US
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Telephone | 510-834-3100
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Fax | 510-834-2988
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LARRY T BUI
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Credential |
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Telephone | 510-839-7900
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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 | PHY47437
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PHY47437
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License Number State | CA
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