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General NPI Number Information
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NPI Number | 1013957786
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Entity Type | Organization
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Legal Business Name | SPECIALTY OXYGEN SERVICES, INC.
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 10/26/2012
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Provider Practice Location Address
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Address Line | 130 PERIMETER PARK ROAD SUITE H & I
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City | KNOXVILLE
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State | TN
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Zip | 37922-2103
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Country | US
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Telephone | 865-531-0281
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Fax | 865-531-0283
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Provider Business Mailing Address
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Address Line | P.O. BOX 1480
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City | SODDY DAISY
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State | TN
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Zip | 37379
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Country | US
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Telephone | 865-531-0281
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Fax | 865-531-0283
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Authorized Official
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Title or Position | PRESIDENT
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Name | KIMBERLY DENEISE STANDEFER
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Credential | RN, BS
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Telephone | 423-802-5143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 0000000855
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License Number State | TN
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