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
—
—
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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