1053318667 NPI number — OXY-MED HOMECARE EQUIPMENT CORP.

Table of content: (NPI 1053318667)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053318667 NPI number — OXY-MED HOMECARE EQUIPMENT CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OXY-MED HOMECARE EQUIPMENT CORP.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053318667
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 SPRUCE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TRENTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08638-3935
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-393-4949
Provider Business Mailing Address Fax Number:
609-393-3009

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 SPRUCE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TRENTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08638-3935
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-393-4949
Provider Business Practice Location Address Fax Number:
609-393-3009
Provider Enumeration Date:
06/29/2005

Additional Information

Authorized Official

Authorized Official Last Name:
KHAN
Authorized Official First Name:
SHON
Authorized Official Middle Name:
M
Authorized Official Title or Position:
MANAGING DIRECTOR
Authorized Official Telephone Number:
609-393-4949

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0002668000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 56733 . This is a "NORTHWOOD NPN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0002668000 . This is a "KEYSTONE HEALTH PLAN EAST" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0002668000 . This is a "KEYSTONE 65" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0002668000 . This is a "KEYSTONE 65" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 45802 . This is a "AETNA USHC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: ME0000090-00 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0002668000 . This is a "AMERIHEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 200011 . This is a "PERSONAL CHOICE BCBS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 228782324 . This is a "CONSUMER HEALTH NETWORK" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 49452 . This is a "AMERIGROUP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0002668000 . This is a "KEYSTONE HEALTH PLAN EAST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3315100 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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