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General NPI Number Information
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NPI Number | 1396823803
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Entity Type | Organization
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Legal Business Name | WHITE OAK DRUG
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 88 UNION AVE
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City | NUTLEY
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State | NJ
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Zip | 07110-3374
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Country | US
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Telephone | 973-667-1434
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Fax | 973-667-9755
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Provider Business Mailing Address
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Address Line | 88 UNION AVE
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City | NUTLEY
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State | NJ
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Zip | 07110-3374
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Country | US
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Telephone | 973-667-1434
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Fax | 973-667-9755
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Authorized Official
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Title or Position | RPIC
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Name | DR. VISHAL CHHABRIA
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Credential |
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Telephone | 973-667-1434
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28RS00154100
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License Number State | NJ
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