River Oak Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

RIVER OAK PHARMACY

Practice address

1080 W F St
Ste D
Oakdale, CA 95361-3677

Phone

(209) 847-2226

Fax

(209) 847-2241

NPI assigned

Aug 10, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tareq Al Mughazzez, RPHNPI 1558790014

Title

Ceo

Phone

(209) 847-2226

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• River Oak Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Tax ID family

River Oak Pharmaceutical Care Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• River Oak Pharmacy

  • Long Term Care Pharmacy
  • Oakdale, CA
  • NPI 1538887500
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tareq Ahmad Al Mughazzez

  • Pharmacist
  • Oakdale, CA
  • NPI 1558790014
  NPD Authorized official
• Kenneth Cosner, PHARM.D.

  • Pharmacist
  • Oakdale, CA
  • NPI 1336555952
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1164433652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 W F ST",
            "address_2": "STE D",
            "city": "OAKDALE",
            "state": "CA",
            "postal_code": "953613677",
            "telephone_number": "209-847-2226",
            "fax_number": "209-847-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 W F ST",
            "address_2": "STE D",
            "city": "OAKDALE",
            "state": "CA",
            "postal_code": "953613677",
            "telephone_number": "209-847-2226",
            "fax_number": "209-847-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER OAK PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "AL MUGHAZZEZ",
        "authorized_official_first_name": "TAREQ",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-847-2226",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164433652",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY PERMIT",
            "identifier": "PHY59988",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Oak Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Noah Reese
• Larry Robert Reis, RPH
• Corina Rae Reveles, APCC
• Dilina Estelle Rigmaiden
• River Oak Dental Spa Dental Office of Tourtlotte Dental Corporation
• River Oak Pharmacy
• Stacey Suzanne Robbins-Podvin, LCSW
• Aurora Rosales, FNP
• Guadalupe Ruelas-French, B.A.
• Ashlynn N Rushing

• Community/Retail Pharmacy in Oakdale, CA
• Providers in Oakdale, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.