Provider Demographics
NPI:1235311572
Name:OAK RIDGE HEALTH SYSTEMS INC
Entity Type:Organization
Organization Name:OAK RIDGE HEALTH SYSTEMS INC
Other - Org Name:OAK RIDGE HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-666-0891
Mailing Address - Street 1:4180B OAK RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36619-1851
Mailing Address - Country:US
Mailing Address - Phone:251-338-0519
Mailing Address - Fax:251-338-0520
Practice Address - Street 1:4180B OAK RIDGE AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36619-1851
Practice Address - Country:US
Practice Address - Phone:251-338-0519
Practice Address - Fax:251-338-0520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1126453336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1995542OtherPK
AL009309140Medicaid
0563460002Medicare NSC