Provider Demographics
NPI:1154803831
Name:OAKS PHARMACY, LLC
Entity type:Organization
Organization Name:OAKS PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HIREN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAYAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-844-9370
Mailing Address - Street 1:238 DANDELION TRL
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-4478
Mailing Address - Country:US
Mailing Address - Phone:810-240-0727
Mailing Address - Fax:
Practice Address - Street 1:2116 N HIGHWAY 81
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1532
Practice Address - Country:US
Practice Address - Phone:864-844-9370
Practice Address - Fax:864-844-9027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-30
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC718255Medicaid