MEDICARE: HOMETOWN OXYGEN PITTSBURGH L.L.C.

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	332BX2000X	Oxygen Equipment & Supplies (DME)	3000008107	PA

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

General Provider Information

NPI Number	:	1811381171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMETOWN OXYGEN PITTSBURGH L.L.C.

Provider Business Mailing Address
First Line	:	400 RODI RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15235-4519
Country	:	US
Telephone Number	:	412-371-0661
Fax Number	:	412-242-4489

Provider Business Practice Location Address
First Line	:	400 RODI RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15235-4519
Country	:	US
Telephone Number	:	412-371-0661
Fax Number	:	412-242-4489

Authorized Official
Title or Position	:	VICE PRESIDENT OF WESTERN REGION
Name	:	MR. MIKE CONNOR
Credential	:
Telephone Number	:	412-371-0661

Provider Enumeration Date	:	03/25/2015
Last Update Date	:	03/25/2015

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