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General NPI Number Information
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NPI Number | 1528380052
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Entity Type | Individual
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Provider Name | JESSICA OXENDINE PHARMD, MBA
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Gender | Female
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Dates
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Enumeration Date | 02/25/2010
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Last Update Date | 08/11/2014
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Provider Practice Location Address
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Address Line | 1008 OAKLAND AVE
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City | ROCK HILL
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State | SC
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Zip | 29732-3035
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Country | US
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Telephone | 803-980-1350
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Fax |
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Provider Business Mailing Address
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Address Line | 3188 PINE BLUFF WAY
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City | FORT MILL
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State | SC
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Zip | 29707-7786
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Country | US
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Telephone | 803-493-2583
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 12648
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License Number State | SC
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