MEDICARE: THE OXYGEN COMPANY, INC

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	0206008411	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	063926	OTHER	VA	ANTHEM PROVIDER NUMBER
3	82-00021	OTHER	VA	UNITED HEALTHCARE
4	247648	OTHER	VA	MAMSI PROVIDER NUMBER
5	63046	OTHER	VA	SOUTHERN HEALTH PROVIDER
6	10393	OTHER	VA	CARENET PROVIDER NUMBER

General Provider Information

NPI Number	:	1275523797
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE OXYGEN COMPANY, INC

Provider Business Mailing Address
First Line	:	8143 STAPLES MILL RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23228-2751
Country	:	US
Telephone Number	:	804-266-2002
Fax Number	:	804-266-1025

Provider Business Practice Location Address
First Line	:	8143 STAPLES MILL RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23228-2751
Country	:	US
Telephone Number	:	804-266-2002
Fax Number	:	804-266-1025

Authorized Official
Title or Position	:	PRESIDENT-CEO
Name	:	MR. HORACE WAYNE SALE
Credential	:
Telephone Number	:	804-673-8966

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	11/07/2011

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