Provider Demographics
NPI:1033220702
Name:SOPOREX DME, INC.
Entity Type:Organization
Organization Name:SOPOREX DME, INC.
Other - Org Name:MITCHELL OXYGEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:SABOLIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-330-0615
Mailing Address - Street 1:102 SAINT FRANCIS ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT
Mailing Address - State:MO
Mailing Address - Zip Code:63857-1952
Mailing Address - Country:US
Mailing Address - Phone:573-888-1773
Mailing Address - Fax:573-888-2105
Practice Address - Street 1:102 SAINT FRANCIS ST
Practice Address - Street 2:
Practice Address - City:KENNETT
Practice Address - State:MO
Practice Address - Zip Code:63857-1952
Practice Address - Country:US
Practice Address - Phone:573-888-1773
Practice Address - Fax:573-888-2105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies