Healthcare Provider Details

I. General information

NPI: 1043861768
Provider Name (Legal Business Name): OXFORD RX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2019
Last Update Date: 11/22/2022
Certification Date: 11/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 N LAMAR BLVD
OXFORD MS
38655-2841
US

IV. Provider business mailing address

212 SAINT ANDREWS CIR
OXFORD MS
38655-2520
US

V. Phone/Fax

Practice location:
  • Phone: 662-380-5300
  • Fax:
Mailing address:
  • Phone: 662-607-8794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MARY JOHN WHITE
Title or Position: OWNER/PHARMACIST
Credential:
Phone: 662-380-5300