Provider Demographics
NPI:1154503746
Name:SILVER OAK PHARMACY INC
Entity Type:Organization
Organization Name:SILVER OAK PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AXAY
Authorized Official - Middle Name:B
Authorized Official - Last Name:JOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:B,SC
Authorized Official - Phone:718-240-9924
Mailing Address - Street 1:5105 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-3511
Mailing Address - Country:US
Mailing Address - Phone:718-240-9924
Mailing Address - Fax:718-240-9211
Practice Address - Street 1:5105 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-3511
Practice Address - Country:US
Practice Address - Phone:718-240-9924
Practice Address - Fax:718-240-9211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0279643336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY027964OtherPHARMACY REGISTRATION NUM
NY027964OtherPHARMACY REGISTRATION NUM