Healthcare Provider Details

I. General information

NPI: 1407521966
Provider Name (Legal Business Name): MEDX ONE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2021
Last Update Date: 08/24/2021
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 N COLORADO ST
CHANDLER AZ
85225-1123
US

IV. Provider business mailing address

3280 N COLORADO ST
CHANDLER AZ
85225-1123
US

V. Phone/Fax

Practice location:
  • Phone: 480-272-4580
  • Fax:
Mailing address:
  • Phone: 480-272-4580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. DENNIS CHIONG
Title or Position: PRESIDENT & CEO
Credential:
Phone: 480-272-4580