Provider Demographics
NPI:1851475982
Name:OCEANSIDE INTERNATIONAL INC
Entity Type:Organization
Organization Name:OCEANSIDE INTERNATIONAL INC
Other - Org Name:PX EXPRESS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RISPER
Authorized Official - Middle Name:
Authorized Official - Last Name:ABUGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-513-1900
Mailing Address - Street 1:789 E PARK ROW DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-4408
Mailing Address - Country:US
Mailing Address - Phone:972-513-1900
Mailing Address - Fax:972-513-1400
Practice Address - Street 1:789 E PARK ROW DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-4408
Practice Address - Country:US
Practice Address - Phone:972-513-1900
Practice Address - Fax:972-513-1400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX218693336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145194Medicaid
2097630OtherPK