Provider Demographics
NPI:1952813982
Name:OAK RIDGE PHARMACY
Entity Type:Organization
Organization Name:OAK RIDGE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUBRAMANIAM
Authorized Official - Middle Name:K
Authorized Official - Last Name:RANGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-274-9943
Mailing Address - Street 1:505 COLUMBIA AVE E
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-5412
Mailing Address - Country:US
Mailing Address - Phone:269-274-9943
Mailing Address - Fax:269-224-6335
Practice Address - Street 1:505 COLUMBIA AVE E
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-5412
Practice Address - Country:US
Practice Address - Phone:269-274-9943
Practice Address - Fax:269-224-6335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302042361333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy