Provider Demographics
NPI:1043365711
Name:PURE OXYGEN SERVICES LLC.
Entity Type:Organization
Organization Name:PURE OXYGEN SERVICES LLC.
Other - Org Name:NU 4 U LLC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-342-1800
Mailing Address - Street 1:4105 S. CHARLESTON PIKE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45502-9375
Mailing Address - Country:US
Mailing Address - Phone:937-342-1800
Mailing Address - Fax:937-342-1801
Practice Address - Street 1:4105 S CHARLESTON PIKE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45502-9375
Practice Address - Country:US
Practice Address - Phone:937-342-1800
Practice Address - Fax:937-342-1801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH021527150332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2547677Medicaid