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General NPI Number Information
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NPI Number | 1669972121
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Entity Type | Organization
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Legal Business Name | OAK HEALTHCARE INC
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 06/06/2018
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Provider Practice Location Address
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Address Line | 2339 W HAMMER LN STE J
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City | STOCKTON
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State | CA
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Zip | 95209-2368
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Country | US
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Telephone | 209-477-7100
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Fax | 209-477-7111
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Provider Business Mailing Address
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Address Line | 2339 W HAMMER LN STE J
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City | STOCKTON
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State | CA
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Zip | 95209-2368
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Country | US
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Telephone | 209-477-7100
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Fax | 209-477-7111
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Authorized Official
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Title or Position | OWNER,RPH,AO
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Name | AMIR KHAN
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Credential |
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Telephone | 209-477-7100
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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 | 3336L0003X
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Taxonomy Name | Long Term Care 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 | 56015
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License Number State | CA
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