Healthcare Provider Details

I. General information

NPI: 1619995321
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: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 S MULBERRY ST
WILMINGTON OH
45177-2202
US

IV. Provider business mailing address

164 S MULBERRY ST
WILMINGTON OH
45177-2202
US

V. Phone/Fax

Practice location:
  • Phone: 937-783-3999
  • Fax: 937-783-3995
Mailing address:
  • Phone: 937-783-3999
  • Fax: 937-783-3995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberHMER.22296
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number02-1133900
License Number StateOH

VIII. Authorized Official

Name: MR. RIC WREN
Title or Position: PRESIDENT
Credential:
Phone: 877-820-9391