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Organization
RIVER OAK PHARMACY
Active
Organization
RIVER OAK PHARMACY
Active
Other names
River Oak Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAREQ AHMAD AL MUGHAZZEZ RPH (CEO)
(209) 847-2226
Entity
Organization
Contact information
Practice address
1080 W F ST STE D, OAKDALE, CA 95361-3677
(209) 847-2226
(209) 847-2241
Mailing address
1080 W F ST STE D, OAKDALE, CA 95361-3677
(209) 847-2226
(209) 847-2241
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY59988
PHARMACY PERMIT
CA
Enumeration date
08/16/2022
Last updated
11/11/2024
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