Provider Demographics
NPI:1659386282
Name:OLIGOI, INC
Entity Type:Organization
Organization Name:OLIGOI, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHCY DIR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-732-4565
Mailing Address - Street 1:PO BOX 277
Mailing Address - Street 2:
Mailing Address - City:ELKMONT
Mailing Address - State:AL
Mailing Address - Zip Code:35620-0277
Mailing Address - Country:US
Mailing Address - Phone:256-732-4565
Mailing Address - Fax:
Practice Address - Street 1:25462 HL HWY 127
Practice Address - Street 2:
Practice Address - City:ELKMONT
Practice Address - State:AL
Practice Address - Zip Code:35620
Practice Address - Country:US
Practice Address - Phone:256-732-4565
Practice Address - Fax:256-732-4988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
AL1127743336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1995866OtherPK