Provider Demographics
NPI:1568983831
Name:MEDXOOM, INC.
Entity Type:Organization
Organization Name:MEDXOOM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PRODUCT OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:HORACIO
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-660-2469
Mailing Address - Street 1:675 PONCE DE LEON AVE NE STE 8500
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-1884
Mailing Address - Country:US
Mailing Address - Phone:404-660-2469
Mailing Address - Fax:
Practice Address - Street 1:675 PONCE DE LEON AVE NE STE 8500
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-1884
Practice Address - Country:US
Practice Address - Phone:404-660-2469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management