MEDICARE: OXYAIR MEDICAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1073521407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OXYAIR MEDICAL LLC

Provider Business Mailing Address
First Line	:	PO BOX 158
Second Line	:
City	:	UNIONVILLE
State	:	CT
Zip	:	06085-0158
Country	:	US
Telephone Number	:	860-677-2122
Fax Number	:	860-677-2419

Provider Business Practice Location Address
First Line	:	471 NEW BRITAIN AVE
Second Line	:
City	:	UNIONVILLE
State	:	CT
Zip	:	06085-1438
Country	:	US
Telephone Number	:	860-677-2122
Fax Number	:	860-677-2419

Authorized Official
Title or Position	:	MEMBER
Name	:	MR. RAYMOND RICHARD BOUCHARD JR.
Credential	:
Telephone Number	:	860-677-2122

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	02/08/2008

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Directions to “OXYAIR MEDICAL LLC ” Practice Location

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