Organization
FRUITVALE AVENUE PHARMACY INC
Active
Other names
Fruitvale Avenue Pharmacy inc
Organization subpart
No
Provider details
NPI number
Authorized official
KALPESH PATEL RPH (PHARMACIST/OWNER)
(510) 406-3089
Entity
Organization
Contact information
Practice address
2693 FRUITVALE AVE, OAKLAND, CA 94601-2034
(510) 261-1412
(510) 261-1414
Mailing address
7400 MACARTHUR BLVD STE B, OAKLAND, CA 94605-2939
(510) 261-1412
(510) 261-1414
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
50064
CA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2122526
PK
—
Enumeration date
10/22/2009
Last updated
07/17/2015
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