Provider Demographics
NPI:1306243829
Name:OASIS MEDICAL LLC
Entity type:Organization
Organization Name:OASIS MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-230-2018
Mailing Address - Street 1:325 FRONT ST
Mailing Address - Street 2:#330
Mailing Address - City:EVANSTON
Mailing Address - State:WY
Mailing Address - Zip Code:82930-3633
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:325 FRONT ST
Practice Address - Street 2:#330
Practice Address - City:EVANSTON
Practice Address - State:WY
Practice Address - Zip Code:82930-3633
Practice Address - Country:US
Practice Address - Phone:877-254-7838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-26
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier