Healthcare Provider Details
I. General information
NPI: 1871035501
Provider Name (Legal Business Name): ALL AMERICAN OXYGEN, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/11/2016
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
359 SKIDMORE DR
HARLAN KY
40831-2544
US
IV. Provider business mailing address
220 W GERMANTOWN PIKE STE 250
PLYMOUTH MEETING PA
19462-1437
US
V. Phone/Fax
- Phone: 606-256-0814
- Fax: 606-256-0849
- Phone: 610-630-6357
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHEN
P
GRIGGS
Title or Position: CEO
Credential:
Phone: 407-206-0040