Provider Demographics
NPI:1033935200
Name:OAKS SPECIALTY PHARMACY, INC
Entity type:Organization
Organization Name:OAKS SPECIALTY PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIZAMUDDIN
Authorized Official - Middle Name:IDRIS
Authorized Official - Last Name:MOHAMMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-820-9159
Mailing Address - Street 1:205 S MAIN ST STE 1005
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-6388
Mailing Address - Country:US
Mailing Address - Phone:469-820-9159
Mailing Address - Fax:
Practice Address - Street 1:205 S MAIN ST STE 1005
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-6388
Practice Address - Country:US
Practice Address - Phone:469-820-9159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy