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General NPI Number Information
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NPI Number | 1528325743
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Entity Type | Organization
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Legal Business Name | BIG OAK PHARMACY INC
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 364 W TRENTON AVE SUITE C
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City | MORRISVILLE
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State | PA
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Zip | 19067-2004
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Country | US
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Telephone | 267-797-5030
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Fax | 267-797-5060
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Provider Business Mailing Address
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Address Line | PO BOX 428
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City | LEVITTOWN
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State | PA
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Zip | 19058-0428
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Country | US
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Telephone | 267-797-5030
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Fax | 267-797-5060
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAUSHAL PATEL
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Credential |
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Telephone | 917-667-6989
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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 | PP482261
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License Number State | PA
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