Provider Demographics
NPI:1750608279
Name:MED-X AT HOME
Entity type:Organization
Organization Name:MED-X AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:AUGUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-721-2700
Mailing Address - Street 1:PO BOX 720
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-0720
Mailing Address - Country:US
Mailing Address - Phone:732-721-3700
Mailing Address - Fax:732-721-2860
Practice Address - Street 1:540 BORDENTOWN AVE
Practice Address - Street 2:STE 4550
Practice Address - City:SOUTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08879-1546
Practice Address - Country:US
Practice Address - Phone:732-721-3700
Practice Address - Fax:732-721-2860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies