Provider Demographics
NPI:1972888261
Name:ROLLING OAKS HEALTH SERVICES
Entity Type:Organization
Organization Name:ROLLING OAKS HEALTH SERVICES
Other - Org Name:ROLLING OAKS PHARMACY, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:AMAL
Authorized Official - Middle Name:H
Authorized Official - Last Name:ZEIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH MHA
Authorized Official - Phone:805-557-1006
Mailing Address - Street 1:325 E. ROLLING OAKS DR.
Mailing Address - Street 2:SUITE 140
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1077
Mailing Address - Country:US
Mailing Address - Phone:866-311-1006
Mailing Address - Fax:888-236-7171
Practice Address - Street 1:325 E. ROLLING OAKS DR.
Practice Address - Street 2:SUITE 140
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1077
Practice Address - Country:US
Practice Address - Phone:866-311-1006
Practice Address - Fax:888-236-7171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY46918333600000X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5616606OtherNCPDP