Provider Demographics
NPI:1508883562
Name:OXYMED INC
Entity Type:Organization
Organization Name:OXYMED INC
Other - Org Name:WRENCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RIC
Authorized Official - Middle Name:
Authorized Official - Last Name:WREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-820-9391
Mailing Address - Street 1:9264 COUNTY ROAD 408A
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:76050-4181
Mailing Address - Country:US
Mailing Address - Phone:817-556-2882
Mailing Address - Fax:817-866-4301
Practice Address - Street 1:9264 COUNTY ROAD 408A
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:TX
Practice Address - Zip Code:76050-4181
Practice Address - Country:US
Practice Address - Phone:817-556-2882
Practice Address - Fax:817-866-4301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0084769332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1858037-01Medicaid
TX1858037-01Medicaid