Healthcare Provider Details

I. General information

NPI: 1760629786
Provider Name (Legal Business Name): AIR EXCHANGE OXYGEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2009
Last Update Date: 01/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 S MAIN ST
BUTTE MT
59701-1709
US

IV. Provider business mailing address

35 S MAIN ST
BUTTE MT
59701-1709
US

V. Phone/Fax

Practice location:
  • Phone: 406-782-6708
  • Fax: 406-782-1224
Mailing address:
  • Phone: 406-782-6708
  • Fax: 406-782-1224

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: MR. HENRY K KLOBUCAR
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 406-782-6708