# OAK STREET PHARMACY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Oak Tree Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154336840
- **Authorized official:** MR. JOHN S SHERMAN RPH (OWNER)
- **Authorized official phone:** (503) 585-2877

## Contact information

- **Practice address:** 2940 COMMERCIAL ST SE, SALEM, OR 97302-4552
- **Practice address phone:** (503) 585-2877
- **Practice address fax:** (503) 585-6007
- **Mailing address:** 2940 COMMERCIAL ST SE, SALEM, OR 97302-4552
- **Mailing address phone:** (503) 585-2877
- **Mailing address fax:** (503) 585-6007

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | RP0000552 | OR | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 07/30/2006
- **Last updated:** 09/27/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 170982 | — | OR |
| 05 | — | 231993 | — | OR |
| 01 | — | 38-09639 | NCPDP | OR |