MEDICARE: HOMETOWN OXYGEN CHARLOTTE 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	332BX2000X	Oxygen Equipment & Supplies (DME)	01452	NC

General Provider Information

NPI Number	:	1871738153
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMETOWN OXYGEN CHARLOTTE LLC

Provider Business Mailing Address
First Line	:	41 SPRING ST.
Second Line	:	SUITE 103
City	:	NEW PROVIDENCE
State	:	NJ
Zip	:	07974
Country	:	US
Telephone Number	:	704-782-0222
Fax Number	:	704-784-0055

Provider Business Practice Location Address
First Line	:	369 CONCORD PKWY N
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28027-6734
Country	:	US
Telephone Number	:	704-782-0222
Fax Number	:	704-784-0055

Authorized Official
Title or Position	:	CHIEF COMPLIANCE OFFICER
Name	:	STEPHEN A LARIVIERE
Credential	:
Telephone Number	:	866-776-6782

Provider Enumeration Date	:	12/15/2008
Last Update Date	:	08/03/2024

Similar Medicare Providers

1356890214 — CAROLINAS HOMETOWN RESPIRATORY LLC
Practice Location Address:

371 CONCORD PKWY N
CONCORD, NC
28027-6734

Practice Phone: 888-877-0202
Practice Fax: 866-487-0202

1639017007 — JENNIFER WARNER
Practice Location Address:

1432 OVERLEA PL NW
CONCORD, NC
28027-8129

Practice Phone: 260-450-8429
Practice Fax:

1104765676 — AALIYAH MORTON
Practice Location Address:

8111 CONCORD MILLS BLVD STE 671A
CONCORD, NC
28027-4400

Practice Phone: 864-894-0890
Practice Fax:

1154278463 — ASHLEY MENDEZ-ASCENCIO
Practice Location Address:

795 PUNCHY WAY NW
CONCORD, NC
28027-6955

Practice Phone: 269-359-2533
Practice Fax:

1225404635 — MR. ROBERTO A MARSICO JR. PA-C
Practice Location Address:

391 GEORGE W LILES PKWY NW
CONCORD, NC
28027-8218

Practice Phone: 713-993-7344
Practice Fax:

1831047570 — EXTENTION OF LIFE CARE, LLC
Practice Location Address:

7850 COMMONS PARK CIR NW # 427
CONCORD, NC
28027-4423

Practice Phone: 704-517-4631
Practice Fax:

Directions to “HOMETOWN OXYGEN CHARLOTTE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.