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General NPI Number Information
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NPI Number | 1932240132
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Entity Type | Organization
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Legal Business Name | FAIR OAKS PHARMACY, INC
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1051 E GRAND AVE
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-2504
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Country | US
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Telephone | 805-489-4243
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Fax | 805-489-4116
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Provider Business Mailing Address
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Address Line | 1051 E GRAND AVE
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-2504
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Country | US
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Telephone | 805-489-4243
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Fax | 805-489-4116
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CHHITU N PATEL
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Credential | RPH
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Telephone | 805-489-4243
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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 | PHY47130
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License Number State | CA
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