1295866481 NPI number — HOSPITALITY OXYGEN AND MEDICAL EQUIPMENT, LLC

Table of content: (NPI 1295866481)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295866481 NPI number — HOSPITALITY OXYGEN AND MEDICAL EQUIPMENT, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOSPITALITY OXYGEN AND MEDICAL EQUIPMENT, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295866481
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/25/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23025 N 15TH AVE
Provider Second Line Business Mailing Address:
STE 106
Provider Business Mailing Address City Name:
PHOENIX
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85027-1409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
386-437-4848
Provider Business Mailing Address Fax Number:
866-623-9456

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4601 E MOODY BLVD
Provider Second Line Business Practice Location Address:
UNIT K11
Provider Business Practice Location Address City Name:
BUNNELL
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32110-9017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
386-437-4848
Provider Business Practice Location Address Fax Number:
866-623-9456
Provider Enumeration Date:
03/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HALMAN
Authorized Official First Name:
HAROLD
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
386-437-4848

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X , with the licence number:  04549 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 031379300 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: M2783 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".




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