Provider Demographics
NPI:1770178121
Name:OXENDINE, DWIGHT (RPH)
Entity type:Individual
Prefix:MR
First Name:DWIGHT
Middle Name:
Last Name:OXENDINE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-3223
Mailing Address - Country:US
Mailing Address - Phone:910-875-1032
Mailing Address - Fax:910-848-0730
Practice Address - Street 1:402 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-3223
Practice Address - Country:US
Practice Address - Phone:910-875-1032
Practice Address - Fax:910-848-0730
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC08601183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist