# MAVERICK OXYGEN & RESPIRATORY EQUIPMENT, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Maverick Group, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609020221
- **Authorized official:** MR. SCOTT KITTLESON (PRESIDENT/OWNER)
- **Authorized official phone:** (502) 225-4772

## Contact information

- **Practice address:** 2510 ALLEN LN, LA GRANGE, KY 40031-8580
- **Practice address phone:** (502) 225-4772
- **Practice address fax:** (502) 225-0605
- **Mailing address:** 2510 ALLEN LN, LA GRANGE, KY 40031-8580
- **Mailing address phone:** (502) 225-4772
- **Mailing address fax:** (502) 225-0605

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | MG0450 | KY | Yes |

## Other

- **Enumeration date:** 11/10/2008
- **Last updated:** 11/10/2008