Provider Demographics
NPI:1528380052
Name:OXENDINE, JESSICA (PHARMD, MBA)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:OXENDINE
Suffix:
Gender:F
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3188 PINE BLUFF WAY
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29707-7786
Mailing Address - Country:US
Mailing Address - Phone:803-493-2583
Mailing Address - Fax:
Practice Address - Street 1:1008 OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3035
Practice Address - Country:US
Practice Address - Phone:803-980-1350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-25
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12648183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist