=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053318667
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OXY-MED HOMECARE EQUIPMENT CORP.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/29/2005
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 501 SPRUCE ST
-----------------------------------------------------
City | TRENTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08638-3935
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-393-4949
-----------------------------------------------------
Fax | 609-393-3009
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 501 SPRUCE ST
-----------------------------------------------------
City | TRENTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08638-3935
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-393-4949
-----------------------------------------------------
Fax | 609-393-3009
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING DIRECTOR
-----------------------------------------------------
Name | MR. SHON M KHAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 609-393-4949
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------