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General NPI Number Information
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NPI Number | 1699139386
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Entity Type | Organization
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Legal Business Name | MONTANA OXYGEN LLC
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Dates
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Enumeration Date | 04/08/2016
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Last Update Date | 04/08/2016
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Provider Practice Location Address
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Address Line | 627 WEST JEFFERSON
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City | THREE FORKS
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State | MT
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Zip | 59752-0787
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Country | US
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Telephone | 406-404-4116
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3123
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City | BOZEMAN
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State | MT
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Zip | 59772-3123
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Country | US
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Telephone | 406-404-4116
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Fax | 406-924-6427
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Authorized Official
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Title or Position | CO-OWNER, MANAGER
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Name | MR. MICHAEL LEE LORENZ
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Credential |
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Telephone | 406-209-3190
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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 |
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License Number State |
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