Provider Demographics
NPI:1043362593
Name:MEDOX HEALTHCARE INC
Entity type:Organization
Organization Name:MEDOX HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-796-3033
Mailing Address - Street 1:438 RALEIGH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-6367
Mailing Address - Country:US
Mailing Address - Phone:910-796-3033
Mailing Address - Fax:910-796-8841
Practice Address - Street 1:4620 TRADEMARK DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-3079
Practice Address - Country:US
Practice Address - Phone:919-231-0007
Practice Address - Fax:919-231-6002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704284Medicaid
NC7704284Medicaid