Healthcare Provider Details

I. General information

NPI: 1740490424
Provider Name (Legal Business Name): OXFORD DIABETIC SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 PARK AVE S STE 218
NEW YORK NY
10010
US

IV. Provider business mailing address

304 PARK AVE S STE 218
NEW YORK NY
10010-4301
US

V. Phone/Fax

Practice location:
  • Phone: 800-559-0639
  • Fax: 800-548-6484
Mailing address:
  • Phone: 800-559-0639
  • Fax: 800-548-6484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. EDWARD LETKO
Title or Position: PRESIDENT
Credential:
Phone: 800-559-0639