Oak Lane Pharmacy, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP481792 Issued in PA

Legal business name

OAK LANE PHARMACY, INC

Practice address

6724 Old York Rd
Phila, PA 19126-2840

Phone

(215) 924-9929

NPI assigned

Aug 27, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Juanita Vivian Rathfon

Title

Pharmacy Manager

Phone

(215) 924-9929

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219795200000",
    "number": "1255588687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6724 OLD YORK RD",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191262840",
            "telephone_number": "215-924-9929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6724 OLD YORK RD",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191262840",
            "telephone_number": "215-924-9929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK LANE PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-27",
        "last_updated": "2008-08-27",
        "status": "A",
        "authorized_official_last_name": "RATHFON",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_middle_name": "VIVIAN",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "215-924-9929",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP481792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021085070001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Phila, PA
• Providers in Phila, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.