Provider Demographics
NPI:1295877181
Name:OXFORD MEADOWS FORK CO
Entity type:Organization
Organization Name:OXFORD MEADOWS FORK CO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/CFO/SEC./DIR.
Authorized Official - Prefix:
Authorized Official - First Name:RAMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARAMILY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-925-2860
Mailing Address - Street 1:231 W VERNON AVE.
Mailing Address - Street 2:STE. 100
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037
Mailing Address - Country:US
Mailing Address - Phone:323-232-1111
Mailing Address - Fax:323-232-1113
Practice Address - Street 1:231 W VERNON AVE.
Practice Address - Street 2:STE. 100
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037
Practice Address - Country:US
Practice Address - Phone:323-232-1111
Practice Address - Fax:323-232-1113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2123555OtherPK
CA1234Medicaid