Provider Demographics
NPI:1790025708
Name:OAKS PHARMACY INC
Entity Type:Organization
Organization Name:OAKS PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:AUGUSTUS
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:914-417-8692
Mailing Address - Street 1:417 RIVERDALE AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-2918
Mailing Address - Country:US
Mailing Address - Phone:914-327-3555
Mailing Address - Fax:914-327-3557
Practice Address - Street 1:417 RIVERDALE AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-2918
Practice Address - Country:US
Practice Address - Phone:914-327-3555
Practice Address - Fax:914-327-3557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-27
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1407039969Medicaid
NY6955550001Medicare NSC