Healthcare Provider Details

I. General information

NPI: 1801083027
Provider Name (Legal Business Name): JC HOME OXYGEN AND MEDICAL EQUIPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 05/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 SOMERSET SQUARE
SOMERSET OH
43783
US

IV. Provider business mailing address

PO BOX 763
SOMERSET OH
43783
US

V. Phone/Fax

Practice location:
  • Phone: 740-743-2688
  • Fax: 740-743-2217
Mailing address:
  • Phone: 740-743-2688
  • Fax: 740-743-2217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number89059964
License Number StateOH

VIII. Authorized Official

Name: JOSEPH M AIELLO
Title or Position: OWNER RESPIRATORY THERAPIST
Credential: RCP
Phone: 740-743-2688