MEDICARE: PATHWAYS RESPIRATORY SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1184695405
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATHWAYS RESPIRATORY SERVICES LLC

Provider Business Mailing Address
First Line	:	PO BOX 55490
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73155-0490
Country	:	US
Telephone Number	:	405-605-3736
Fax Number	:	405-605-3763

Provider Business Practice Location Address
First Line	:	3908 N TULSA AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2937
Country	:	US
Telephone Number	:	405-605-3736
Fax Number	:	405-605-3763

Authorized Official
Title or Position	:	OWNER
Name	:	OTIS RAY FOSHEE
Credential	:
Telephone Number	:	405-605-3736

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	04/20/2008

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