Provider Demographics
NPI:1356745251
Name:MEDEX, INC.
Entity type:Organization
Organization Name:MEDEX, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEIGH
Authorized Official - Middle Name:N
Authorized Official - Last Name:LAZARUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-252-0710
Mailing Address - Street 1:1307 W JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-2549
Mailing Address - Country:US
Mailing Address - Phone:765-252-0710
Mailing Address - Fax:765-252-0712
Practice Address - Street 1:1307 W JOHNSON ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-2549
Practice Address - Country:US
Practice Address - Phone:765-252-0710
Practice Address - Fax:765-252-0712
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDEX, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-21
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200936600AMedicaid
IN6228120001Medicare PIN