Provider Demographics
NPI:1154643849
Name:OXYMED HOMECARE EQUIPMENT CORPORATION
Entity Type:Organization
Organization Name:OXYMED HOMECARE EQUIPMENT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHON
Authorized Official - Middle Name:M
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-822-2851
Mailing Address - Street 1:1001 OLD BERWICK RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-2922
Mailing Address - Country:US
Mailing Address - Phone:570-822-2851
Mailing Address - Fax:570-371-5580
Practice Address - Street 1:1001 OLD BERWICK RD
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-2922
Practice Address - Country:US
Practice Address - Phone:570-822-2851
Practice Address - Fax:570-371-5580
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OXYMED HOMECARE EQUIPMENT CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-22
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0426890002Medicare NSC