Healthcare Provider Details

I. General information

NPI: 1154664142
Provider Name (Legal Business Name): WHITFORDS OXYGEN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 LISBON AVE SE
RIO RANCHO NM
87124-3050
US

IV. Provider business mailing address

685 LISBON AVE SE
RIO RANCHO NM
87124-3050
US

V. Phone/Fax

Practice location:
  • Phone: 505-301-0971
  • Fax:
Mailing address:
  • Phone: 505-301-0971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateNM

VIII. Authorized Official

Name: HERSCHAL JOSEPH WHITFORD
Title or Position: OWNER
Credential: RRT
Phone: 505-301-0971