Healthcare Provider Details

I. General information

NPI: 1114039385
Provider Name (Legal Business Name): SNF OXYGEN SERVICESLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/06/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 OTT ST N/A
CORONA CA
92882-1872
US

IV. Provider business mailing address

1107 FAIR OAKS AVE STE 528
SOUTH PASADENA CA
91030-3311
US

V. Phone/Fax

Practice location:
  • Phone: 951-270-5207
  • Fax: 951-898-9991
Mailing address:
  • Phone: 951-270-5207
  • Fax: 951-898-9991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MS. GERRY SUE ABACHERLI
Title or Position: PRESIDENT
Credential: N/A
Phone: 951-270-5207