Provider Demographics
NPI:1235468596
Name:AXIOM LINK, INC.
Entity Type:Organization
Organization Name:AXIOM LINK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:PADRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-684-0099
Mailing Address - Street 1:9620 S PENNSYLVANIA AVE
Mailing Address - Street 2:UNIT C
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-6904
Mailing Address - Country:US
Mailing Address - Phone:405-735-6366
Mailing Address - Fax:405-735-6368
Practice Address - Street 1:9620 S PENNSYLVANIA AVE
Practice Address - Street 2:UNIT C
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6904
Practice Address - Country:US
Practice Address - Phone:405-735-6366
Practice Address - Fax:405-735-6368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200261870 AMedicaid