Organization
SERVICE MEDICAL OXYGEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNY W DAUGHRIETY (OWNER)
(740) 393-0202
Entity
Organization
Contact information
Practice address
410 W HIGH ST, MOUNT VERNON, OH 43050-2325
(740) 393-0202
(740) 392-9700
Mailing address
410 W HIGH ST, MOUNT VERNON, OH 43050-2325
(740) 393-0202
(740) 392-9700
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
42017406
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0570789
—
OH
Enumeration date
09/20/2005
Last updated
08/22/2020
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