Healthcare Provider Details

I. General information

NPI: 1295877181
Provider Name (Legal Business Name): OXFORD MEADOWS FORK CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 10/10/2022
Certification Date: 10/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 W VERNON AVE. STE. 100
LOS ANGELES CA
90037
US

IV. Provider business mailing address

231 W VERNON AVE. STE. 100
LOS ANGELES CA
90037
US

V. Phone/Fax

Practice location:
  • Phone: 323-232-1111
  • Fax: 323-232-1113
Mailing address:
  • Phone: 323-232-1111
  • Fax: 323-232-1113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: RAMY BARAMILY
Title or Position: CEO/CFO/SEC./DIR.
Credential:
Phone: 310-925-2860