Healthcare Provider Details
I. General information
NPI: 1467432799
Provider Name (Legal Business Name): COMMUNITY HOME OXYGEN INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/20/2006
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5050 HARRISON AVE STE 5
BUTTE MT
59701-7033
US
IV. Provider business mailing address
PO BOX 27968
SALT LAKE CITY UT
84127-0968
US
V. Phone/Fax
- Phone: 406-494-6900
- Fax: 406-494-6906
- Phone: 570-966-8030
- Fax: 570-966-8040
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| 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 | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
ROBIN
L
MENCHEN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 407-822-4600