Provider Demographics
NPI:1295574697
Name:OAK TOWN LLC
Entity type:Organization
Organization Name:OAK TOWN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ASIM
Authorized Official - Middle Name:
Authorized Official - Last Name:JAVED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-702-9452
Mailing Address - Street 1:8741 S OAK PARK DR APT 3
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-3821
Mailing Address - Country:US
Mailing Address - Phone:414-702-9452
Mailing Address - Fax:
Practice Address - Street 1:8741 S OAK PARK DR APT 3
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-3821
Practice Address - Country:US
Practice Address - Phone:414-702-9452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies