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General NPI Number Information
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NPI Number | 1326562661
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Entity Type | Organization
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Legal Business Name | THE OAK CLINIC
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Dates
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Enumeration Date | 07/28/2017
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 3838 MASSILLON ROAD SUITE 365
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City | UNIONTOWN
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State | OH
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Zip | 44685-6215
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Country | US
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Telephone | 234-251-1105
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Fax | 234-251-1104
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Provider Business Mailing Address
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Address Line | 1620 W NORTHWEST HWY SUITE 100
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City | GRAPEVINE
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State | TX
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Zip | 76051-3119
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Country | US
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Telephone | 817-572-0009
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Fax | 817-572-0221
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Authorized Official
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Title or Position | MANAGING OFFICER
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Name | PATRICIA JONES
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Credential |
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Telephone | 817-572-0009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 22762500
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License Number State | OH
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