Organization
PROFESSIONAL OXYGEN SUPPLY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARK MCINROY (CEO)
(307) 632-4147
Entity
Organization
Contact information
Practice address
417 W BUFFALO ST, RAWLINS, WY 82301-5621
(307) 328-1357
Mailing address
600 E CARLSON ST STE 101, CHEYENNE, WY 82009-4271
(307) 632-4147
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106001500
—
WY
Enumeration date
07/07/2005
Last updated
01/23/2019
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