Provider Demographics
NPI:1821165325
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:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:NEMYER
Authorized Official - Suffix:
Authorized Official - Credentials:CRTT
Authorized Official - Phone:660-686-2405
Mailing Address - Street 1:PO BOX 237
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:MO
Mailing Address - Zip Code:64446-0237
Mailing Address - Country:US
Mailing Address - Phone:660-686-2405
Mailing Address - Fax:660-686-2670
Practice Address - Street 1:26146 US HWY 59
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:MO
Practice Address - Zip Code:64446-0237
Practice Address - Country:US
Practice Address - Phone:660-686-2405
Practice Address - Fax:660-686-2670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO13602012332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO156350OtherBCBS OF MISSOURI
SD9162620Medicaid
WA336064OtherCOMBINED INS COMPANY
IA0950931Medicaid
MO14188017OtherBCBS OF KANSAS CITY
TXD0229930001OtherUNITED AMERICAN INS CO
MO156350OtherBCBS OF MISSOURI