Healthcare Provider Details

I. General information

NPI: 1689748303
Provider Name (Legal Business Name): COMMUNITY OXYGEN SERVICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 CHESTNUT ST
NEW ORLEANS LA
70115-3615
US

IV. Provider business mailing address

3600 CHESTNUT ST 3RD FLOOR
NEW ORLEANS LA
70115
US

V. Phone/Fax

Practice location:
  • Phone: 504-894-9729
  • Fax: 504-620-1097
Mailing address:
  • Phone: 504-894-9729
  • Fax: 504-620-1097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5087
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number5087
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number5087
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number5087
License Number StateLA
# 5
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number5087
License Number StateLA

VIII. Authorized Official

Name: PAUL KAVANAUGH
Title or Position: CEO
Credential:
Phone: 504-894-9729