Organization
OXYGEN STORE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROMONA JEAN HARMAN (PRESIDENT)
(419) 947-9502
Entity
Organization
Contact information
Practice address
14 NORTH CHERRY STREET, MOUNT GILEAD, OH 43338
(419) 947-9502
(419) 947-9902
Mailing address
14 NORTH CHERRY STREET, MOUNT GILEAD, OH 43338
(419) 947-9502
(419) 947-9902
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
59-009271
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000309733
ANTHEM BC/BS
OH
05
—
2425174
—
OH
Enumeration date
06/22/2006
Last updated
10/26/2011
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