# MOUNTAIN AIR OXYGEN SERVICE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164429650
- **Authorized official:** SUSANNE L KANEN (OWNER/PRESIDENT)
- **Authorized official phone:** (719) 589-4112

## Contact information

- **Practice address:** 2415 MULLINS AVE., ALAMOSA, CO 81101-4264
- **Practice address phone:** (719) 589-2573
- **Practice address fax:** (719) 589-8891
- **Mailing address:** 2415 MULLINS AVE., ALAMOSA, CO 81101-4264
- **Mailing address phone:** (719) 589-2573
- **Mailing address fax:** (719) 589-8891

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | 07150460001 | CO | — |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | NULL | Yes |

## Other

- **Enumeration date:** 06/30/2005
- **Last updated:** 12/02/2011