Provider Demographics
NPI:1760630958
Name:OAKLAND PHARMACY RX, LLC
Entity Type:Organization
Organization Name:OAKLAND PHARMACY RX, LLC
Other - Org Name:OAKLAND DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MANDALAPU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-306-9966
Mailing Address - Street 1:350 RAMAPO VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-2702
Mailing Address - Country:US
Mailing Address - Phone:201-337-7300
Mailing Address - Fax:201-337-6188
Practice Address - Street 1:350 RAMAPO VALLEY RD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-2702
Practice Address - Country:US
Practice Address - Phone:201-337-7300
Practice Address - Fax:201-337-6188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00682500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RS00682500OtherPHARMACY LICENSE