Oak Healthcare Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

56015 Issued in CA

Legal business name

OAK HEALTHCARE INC

Practice address

2339 W Hammer LN Ste J
Stockton, CA 95209-2368

Phone

(209) 477-7100

Fax

(209) 477-7111

NPI assigned

Feb 20, 2018

Organization subpart

No

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

Authorized official

Name

Amir Khan

Title

Owner,RPH,Ao

Phone

(209) 477-7100

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Hammer Lane Pharmacy Other name

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Tax ID family

Hammer Lane Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Oak Healthcare Inc

  • Health Service Clinic/Center
  • Stockton, CA
  • NPI 1497634240
  NPD tax ID
• Oak Healthcare Inc

  • Long Term Care Pharmacy
  • Stockton, CA
  • NPI 1992584437
  NPD tax ID

Locations

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528243200000",
    "number": "1669972121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2339 W HAMMER LN STE J",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092368",
            "telephone_number": "209-477-7100",
            "fax_number": "209-477-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2339 W HAMMER LN STE J",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092368",
            "telephone_number": "209-477-7100",
            "fax_number": "209-477-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-06-06",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "AMIR",
        "authorized_official_title_or_position": "OWNER,RPH,AO",
        "authorized_official_telephone_number": "209-477-7100"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "56015",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176045",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hammer Lane Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Paul Thomas O'Donnell, LMFT
• Alondra Michaele O'Leary
• Rosalie O'Neal
• Mary Ann O'Neill, MFT
• Oak Healthcare Inc
• Oak Healthcare Inc
• Oak Park Health Care Center
• Marya W Oakes, FNP
• Susan Jeanne Oase, RN, FNP
• Jory Ober

• Community/Retail Pharmacy in Stockton, CA
• Providers in Stockton, 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 Jun 6, 2018; 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.