Organization
PROFESSIONAL OXYGEN SUPPLY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEENA RONEICE NEAL C.R.T. (PRESIDENT)
(307) 328-1357
Entity
Organization
Contact information
Practice address
1804 DUNDEE DR, RAWLINS, WY 82301
(307) 328-1357
Mailing address
417 W BUFFALO ST, RAWLINS, WY 82301-5621
(307) 328-1357
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
303840
BCBS PROVIDER NUMBER
WY
Enumeration date
11/08/2006
Last updated
07/17/2007
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