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Fruitvale Avenue Pharmacy, Inc.

Debarred entity

Fruitvale Avenue Pharmacy, Inc. is an entity of interest. It has not been found on international sanctions lists.

Type	Company				[sources]
Name	Fruitvale Avenue Pharmacy, Inc.				[sources]
Incorporation date	not available				[sources]
Jurisdiction	not available				[sources]
Country	United States				[sources]
NPI	`1619203841`				[sources]
Registration number	`PHY 537537`				[sources]
Sector	Entity/Corporation				[sources]
Address	2693 Fruitvale Ave., Oakland, CA, 94601				[sources]
Last change	2024-12-12	Last processed	2025-10-15	First seen	2024-11-07

Sanctions
Country	Authority	Program	Start date	End date
United States	Department of Health Care Services		2020-12-09	-

Medical providers suspended from or otherwise deemed ineligible to participate in California's Medicaid program.

United States of America · DHCS

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