Healthcare Provider Details

I. General information

NPI: 1538187232
Provider Name (Legal Business Name): OXYMED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 01/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 E MAIN ST SUITE 101
HILLSBORO OH
45133-1612
US

IV. Provider business mailing address

144 E MAIN ST SUITE 101
HILLSBORO OH
45133-1612
US

V. Phone/Fax

Practice location:
  • Phone: 937-840-9047
  • Fax: 937-840-0984
Mailing address:
  • Phone: 937-840-9047
  • Fax: 937-840-0984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberHMER.22300
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number02-1401900
License Number StateOH

VIII. Authorized Official

Name: RIC WREN
Title or Position: PRESIDENT
Credential:
Phone: 937-840-9047