Organization
COMMUNITY OXYGEN SERVICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL B KAVANAUGH (CHIEF EXECUTIVE OFFICER)
(504) 899-2500
Entity
Organization
Contact information
Practice address
1501 KUEBEL ST STE C, HARAHAN, LA 70123-6961
(504) 894-9729
Mailing address
1501 KUEBEL ST, STE C, HARAHAN, LA 70123
(504) 894-9729
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
360010426
LA
333600000X
Pharmacy
5087IR
LA
3336C0003X
Community/Retail Pharmacy
5087IR
LA
3336I0012X
Institutional Pharmacy
5087IR
LA
3336M0002X
Mail Order Pharmacy
5087IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2535692
—
LA
Enumeration date
11/30/2005
Last updated
01/05/2022
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