Healthcare Provider Details

I. General information

NPI: 1790536969
Provider Name (Legal Business Name): OXFORD OPERATOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PROSPECT AVE
OXFORD NC
27565-2543
US

IV. Provider business mailing address

500 PROSPECT AVE
OXFORD NC
27565-2543
US

V. Phone/Fax

Practice location:
  • Phone: 919-693-1531
  • Fax:
Mailing address:
  • Phone: 919-693-1531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: CRAIG NEISWANGER
Title or Position: AUTHORIZED AGENT
Credential:
Phone: 919-693-1531