Basic Information
| Provider Information | |||||||||
| NPI: | 1376560326 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | OXYMED INC | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | WRENCARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3200 PHYSICIANS WAY | ||||||||
| Address2: | SUITE B | ||||||||
| City: | SEBRING | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338705447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8778209391 | ||||||||
| FaxNumber: | 5137054221 | ||||||||
| Practice Location | |||||||||
| Address1: | 3200 PHYSICIANS WAY | ||||||||
| Address2: | SUITE B | ||||||||
| City: | SEBRING | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338705447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8778209391 | ||||||||
| FaxNumber: | 5137054221 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| AuthorizedOfficialLastName: | WREN | ||||||||
| AuthorizedOfficialFirstName: | RIC | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8778209391 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | FL | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.