Provider Demographics
NPI:1891702510
Name:MED INC
Entity Type:Organization
Organization Name:MED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MENCHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-822-4600
Mailing Address - Street 1:PO BOX 27968
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0968
Mailing Address - Country:US
Mailing Address - Phone:570-966-8030
Mailing Address - Fax:570-966-8040
Practice Address - Street 1:485 SOUTHLAKE BLVD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3044
Practice Address - Country:US
Practice Address - Phone:804-674-6688
Practice Address - Fax:804-674-6610
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROTECH HEALTHCARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-02
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0206009137332B00000X
332BC3200X, 332BP3500X, 332BX2000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009104682Medicaid
VA009104682Medicaid