Provider Information for 1578856316
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OAKLEY PHARMACY INC
Other Names:Doing Business As:DALE HOLLOW PHARMACYOrganization Subpart: NO
NPI: 1578856316
Last Updated: 2016-11-30
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1578856316 | ||||||||||||
| Enumeration Date | 2011-05-26 | ||||||||||||
| NPI Type | NPI-2 Organization | ||||||||||||
| Status | Active | ||||||||||||
| Authorized Official Information | Name: JOHN POLSTON Title: PIC Phone: 9312433550 | ||||||||||||
| Mailing Address | PO BOX 188 CELINA, TN 38551-0188 United States Phone: 931-243-3434 | Fax:931-243-3550 | ||||||||||||
| Primary Practice Address | 201 MCARTHUR AVE CELINA, TN 38551-4004 United States Phone: 931-243-3434 | Fax:931-243-3550 | ||||||||||||
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