Healthcare Provider Details
I. General information
NPI: 1518993963
Provider Name (Legal Business Name): PRAXAIR HEALTHCARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/25/2006
Last Update Date: 11/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2621 SW 17TH RD
OCALA FL
34471-2041
US
IV. Provider business mailing address
350 PINE ST SUITE 330
BEAUMONT TX
77701-2437
US
V. Phone/Fax
- Phone: 352-622-4866
- Fax: 352-622-0189
- Phone: 409-951-6179
- Fax: 409-838-6421
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BP3500X |
| Taxonomy | Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SCOTT
KALTRIDER
Title or Position: PRESIDENT
Credential:
Phone: 203-837-2436