Healthcare Provider Details

I. General information

NPI: 1649400771
Provider Name (Legal Business Name): COMMUNITY OXYGEN & MEDICAL EQUIPMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2009
Last Update Date: 07/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 W. 12TH ST.
BEAVER DAM KY
42320-0025
US

IV. Provider business mailing address

PO BOX 25
BEAVER DAM KY
42320-0025
US

V. Phone/Fax

Practice location:
  • Phone: 270-274-5050
  • Fax: 270-274-4071
Mailing address:
  • Phone: 270-274-5050
  • Fax: 270-274-4071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberMG0182
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MS. DEBORAH J DUVALL
Title or Position: PRESIDENT
Credential: RN
Phone: 270-274-5050