Healthcare Provider Details

I. General information

NPI: 1821052267
Provider Name (Legal Business Name): CROSS OXYGEN DELIVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 02/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6111 SUNRAY RD NW
ALBUQUERQUE NM
87120-6140
US

IV. Provider business mailing address

6111 SUNRAY RD NW
ALBUQUERQUE NM
87120-6140
US

V. Phone/Fax

Practice location:
  • Phone: 505-839-2904
  • Fax: 505-839-2904
Mailing address:
  • Phone: 505-839-2904
  • Fax: 505-839-2904

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: KIMBERLY DENISE CROSS
Title or Position: OWNER
Credential:
Phone: 505-839-2904