Fruitvale Avenue Pharmacy INC
Pharmacy, Community/Retail Pharmacy in Oakland, CA. Organization (NPI-2).
NPI number1619203841
StatusActive
Last updated in NPPESJul 17, 2015
Details
- NPI
- 1619203841
- Entity type
- Organization (NPI-2)
- Legal business name
- Fruitvale Avenue Pharmacy INC
- Organization subpart
- No
- Enumeration date
- Oct 22, 2009
- Last updated
- Jul 17, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 50064 | CA | Yes |
| 3336L0003X | Pharmacy, Long Term Care Pharmacy | – | – |
Other names
- Fruitvale Avenue Pharmacy INC (Doing Business As)
Practice location
2693 Fruitvale AveOakland, CA 94601-2034
Phone 510-261-1412 · Fax 510-261-1414
Mailing address
7400 Macarthur Blvd Ste BOakland, CA 94605-2939
Phone 510-261-1412 · Fax 510-261-1414
Authorized official
Kalpesh Patel
Pharmacist/Owner
5104063089
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