Ronmax ENT Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

RONMAX ENT INC

Doing business as

Active Medical

Practice address

195 East E Street
Jacksonville, OR 97530-9246

Phone

(541) 899-2077

Fax

(541) 899-1795

NPI assigned

Jul 10, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ron K Clark

Title

Owner

Phone

(541) 899-2077

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Active Medical Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1851325625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 EAST E STREET",
            "city": "JACKSONVILLE",
            "state": "OR",
            "postal_code": "975309246",
            "telephone_number": "541-899-2077",
            "fax_number": "541-899-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 EAST E STREET",
            "city": "JACKSONVILLE",
            "state": "OR",
            "postal_code": "975309246",
            "telephone_number": "541-899-2077",
            "fax_number": "541-899-1795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONMAX ENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "RON",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-899-2077"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210224",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Jacksonville, OR
• Providers in Jacksonville, OR by specialty
• Durable Medical Equipment & Medical Supplies in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.