MEDICARE: OXYGEN SUPPORT SERVICES, INC

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	332B00000X	Durable Medical Equipment & Medical Supplies	582	FL

General Provider Information

NPI Number	:	1578597415
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OXYGEN SUPPORT SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 15732
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33733-5732
Country	:	US
Telephone Number	:	727-327-7133
Fax Number	:	727-327-6633

Provider Business Practice Location Address
First Line	:	3425 11TH AVE N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33713-5407
Country	:	US
Telephone Number	:	727-327-7133
Fax Number	:	727-327-6633

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. WILLIE JAMES COPPETT
Credential	:	RRT
Telephone Number	:	727-327-7133

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	08/22/2020

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