Provider Demographics
NPI:1710048814
Name:OXY-MED, INC
Entity Type:Organization
Organization Name:OXY-MED, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-592-2771
Mailing Address - Street 1:2601 IOWA ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-4106
Mailing Address - Country:US
Mailing Address - Phone:785-749-2166
Mailing Address - Fax:
Practice Address - Street 1:2601 IOWA ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66046-4106
Practice Address - Country:US
Practice Address - Phone:785-749-2166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200423090AMedicaid
KS118463OtherBC/BS OF KANSAS
KS5861060001Medicare NSC