MEDICARE: OXNARD DRUG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	PHY46460	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0540042	OTHER		NCPDP
2	PHY46460	OTHER	CA	PHARMACY LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467456731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OXNARD DRUG

Provider Business Mailing Address
First Line	:	105 W 5TH ST
Second Line	:
City	:	OXNARD
State	:	CA
Zip	:	93030-7105
Country	:	US
Telephone Number	:	805-483-2115
Fax Number	:	805-483-8585

Provider Business Practice Location Address
First Line	:	105 W 5TH ST
Second Line	:
City	:	OXNARD
State	:	CA
Zip	:	93030-7105
Country	:	US
Telephone Number	:	805-483-2115
Fax Number	:	805-483-8585

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOE MATTHEW HOFFMAN III
Credential	:	RPH
Telephone Number	:	805-483-2115

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	03/07/2023

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Directions to “OXNARD DRUG ” Practice Location

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