Organization
RONMAX ENT INC
Active
Other names
Active Medical
Organization subpart
No
Provider details
NPI number
Authorized official
RON K CLARK (OWNER)
(541) 899-2077
Entity
Organization
Contact information
Practice address
195 EAST E STREET, JACKSONVILLE, OR 97530-9246
(541) 899-2077
(541) 899-1795
Mailing address
195 EAST E STREET, JACKSONVILLE, OR 97530-9246
(541) 899-2077
(541) 899-1795
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210224
—
OR
Enumeration date
07/10/2006
Last updated
09/18/2008
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