Organization
PREMIERE OXYGEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER K WENDELL (MANAGING MEMBER)
(775) 883-2004
Entity
Organization
Contact information
Practice address
3107 N DEER RUN RD, STE. 14, CARSON CITY, NV 89701-2406
(775) 883-2004
(775) 884-4550
Mailing address
3107 N DEER RUN RD, STE. 14, CARSON CITY, NV 89701
(775) 883-2004
(775) 884-4550
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
MP00369
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100509520
—
NV
Enumeration date
05/11/2006
Last updated
12/22/2008
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