Provider Demographics
NPI:1760880397
Name:MEDI OASIS HEALTH SERVICES
Entity Type:Organization
Organization Name:MEDI OASIS HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDRAE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-815-4455
Mailing Address - Street 1:30 OLD KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-4551
Mailing Address - Country:US
Mailing Address - Phone:203-717-6638
Mailing Address - Fax:
Practice Address - Street 1:30 OLD KINGS HWY S
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4551
Practice Address - Country:US
Practice Address - Phone:203-717-6638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-13
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies