# LIQUID BLUE OXYGEN, INC

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

## Provider details

- **NPI number:** 1871671396
- **Authorized official:** DANIELLE D FYOCK II (PRESIDENT)
- **Authorized official phone:** (814) 385-1321

## Contact information

- **Practice address:** 482 DONALDSON RD, KENNERDELL, PA 16374-1504
- **Practice address phone:** (814) 385-1321
- **Practice address fax:** (814) 385-1319
- **Mailing address:** 482 DONALDSON RD, KENNERDELL, PA 16374-1504
- **Mailing address phone:** (814) 385-1321
- **Mailing address fax:** (814) 385-1319

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | 8000001243 | PA | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 08/22/2020