1518049311 NPI number — MED-OX CONCENTRATORS

Table of content: (NPI 1518049311)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518049311 NPI number — MED-OX CONCENTRATORS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MED-OX CONCENTRATORS
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:
1518049311
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1171 LINDY LN NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARROLLTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44615-9364
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-627-2373
Provider Business Mailing Address Fax Number:
330-627-3704

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
52 GALLO RD NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARROLLTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44615-9754
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-627-2373
Provider Business Practice Location Address Fax Number:
330-627-3704
Provider Enumeration Date:
10/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
REED
Authorized Official First Name:
JOY
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
330-627-2373

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X , with the licence number:  021253950 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 06744579 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2864810890200 . This is a "COMMUNITY MUTUAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 34105315700 . This is a "BUREAU OF WORK COMP" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000227514 . This is a "ANTHEM BLUE CROSS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0004366768 . This is a "AETNA ID #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0110296484 . This is a "GE LIFE & ANNUITY" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1403803 . This is a "UNITED MINE WORKERS OF AM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 341053157 . This is a "NORTH AMERICAN COAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 476185 . This is a "BLACK LUNG" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0025168 . This is a "CHAMPUS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1403803 . This is a "UMWA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1774810001 . This is a "BLUE CROSS/BLUE SHIELD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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