Healthcare Provider Details

I. General information

NPI: 1164671863
Provider Name (Legal Business Name): SOUND OXYGEN SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2008
Last Update Date: 05/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 S STATE ST STE 120
OREM UT
84097-7006
US

IV. Provider business mailing address

4108 B PL NW STE B
AUBURN WA
98001-2454
US

V. Phone/Fax

Practice location:
  • Phone: 801-696-8617
  • Fax: 801-766-6343
Mailing address:
  • Phone: 253-939-2752
  • Fax: 253-939-4135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number7017897-1714
License Number StateUT

VIII. Authorized Official

Name: JEREMY K JENSEN
Title or Position: CEO
Credential:
Phone: 253-939-2752