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General NPI Number Information
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NPI Number | 1902523806
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Entity Type | Organization
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Legal Business Name | OAK GROVE PHARMACY
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Dates
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Enumeration Date | 10/21/2022
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | 785 OAK GROVE RD STE G2
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City | CONCORD
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State | CA
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Zip | 94518-3605
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Country | US
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Telephone | 925-681-1823
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Fax | 925-681-1827
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Provider Business Mailing Address
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Address Line | 785 OAK GROVE RD STE G2
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City | CONCORD
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State | CA
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Zip | 94518-3605
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Country | US
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Telephone | 925-681-1823
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Fax | 925-681-1827
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Authorized Official
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Title or Position | OWNER
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Name | NASER A KALIL
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Credential | PHARMD
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Telephone | 925-681-1823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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