Provider Demographics
NPI:1649458886
Name:OTN PARENT CORP.
Entity type:Organization
Organization Name:OTN PARENT CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, MCKESSON SPECIALTY
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-983-9397
Mailing Address - Street 1:395 OYSTER POINT BLVD
Mailing Address - Street 2:#500
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-1928
Mailing Address - Country:US
Mailing Address - Phone:415-983-8619
Mailing Address - Fax:
Practice Address - Street 1:395 OYSTER POINT BLVD
Practice Address - Street 2:#500
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-1928
Practice Address - Country:US
Practice Address - Phone:415-983-8619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCKESSON CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site