Provider Demographics
NPI:1881967974
Name:OXFORD PHARMACY
Entity type:Organization
Organization Name:OXFORD PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:VENKAT
Authorized Official - Middle Name:
Authorized Official - Last Name:GUDIPATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-750-1400
Mailing Address - Street 1:3612 WEDGEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-9318
Mailing Address - Country:US
Mailing Address - Phone:352-750-1400
Mailing Address - Fax:352-750-1480
Practice Address - Street 1:3612 WEDGEWOOD LN
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-9318
Practice Address - Country:US
Practice Address - Phone:352-750-1400
Practice Address - Fax:352-750-1480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH259813336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFS3117860OtherDEA NUMBER