Provider Demographics
NPI:1467456731
Name:OXNARD DRUG
Entity Type:Organization
Organization Name:OXNARD DRUG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:III
Authorized Official - Credentials:RPH
Authorized Official - Phone:805-483-2115
Mailing Address - Street 1:105 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-7105
Mailing Address - Country:US
Mailing Address - Phone:805-483-2115
Mailing Address - Fax:805-483-8585
Practice Address - Street 1:105 W 5TH ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-7105
Practice Address - Country:US
Practice Address - Phone:805-483-2115
Practice Address - Fax:805-483-8585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY46460333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0540042OtherNCPDP
CAPHY46460OtherPHARMACY LICENSE
CAPHA464600Medicaid
CAPHA464600Medicaid
CAPHY46460OtherPHARMACY LICENSE