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NPI Code Detail

MEDICARE: DR. JESSICA OXENDINE PHARMD, MBA

MEDICARE:  DR. JESSICA  OXENDINE  PHARMD, MBA
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
1183500000XPharmacist12648SC

General Provider Information

NPI Number : 1528380052
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JESSICA OXENDINE PHARMD, MBA
Provider Business Mailing Address
First Line : 3188 PINE BLUFF WAY
Second Line :
City : FORT MILL
State : SC
Zip : 29707-7786
Country : US
Telephone Number : 803-493-2583
Fax Number :
Provider Business Practice Location Address
First Line : 1008 OAKLAND AVE
Second Line :
City : ROCK HILL
State : SC
Zip : 29732-3035
Country : US
Telephone Number : 803-980-1350
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2010
Last Update Date : 08/11/2014

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Directions to “ DR. JESSICA OXENDINE PHARMD, MBA” Practice Location

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