Healthcare Provider Details
I. General information
NPI: 1982909743
Provider Name (Legal Business Name): OXYMED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/25/2011
Last Update Date: 04/21/2022
Certification Date: 04/21/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5025 HIGHWAY 280 STE 101
BIRMINGHAM AL
35242
US
IV. Provider business mailing address
5025 HIGHWAY 280 STE 101
BIRMINGHAM AL
35242-5163
US
V. Phone/Fax
- Phone: 205-981-2333
- Fax:
- Phone: 205-981-2333
- Fax: 205-981-2336
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | 900775 |
| License Number State | AL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 1024 |
| License Number State | AL |
VIII. Authorized Official
Name: MR.
JONATHAN
S
TEMPLE
SR.
Title or Position: OWNER
Credential:
Phone: 205-981-2333