Provider Demographics
NPI:1194388702
Name:OAK RIDGE PHARMACY
Entity Type:Organization
Organization Name:OAK RIDGE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:SAAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AQQAD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:865-482-0345
Mailing Address - Street 1:854 MAIN STREET WEST
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830
Mailing Address - Country:US
Mailing Address - Phone:865-482-0345
Mailing Address - Fax:865-482-8814
Practice Address - Street 1:854 MAIN ST W
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830
Practice Address - Country:US
Practice Address - Phone:865-482-0345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2019-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6696OtherBOARD OF PHARMACY LICENSE NUMBER