Provider Demographics
NPI:1073592952
Name:HOME OXYGEN & EQUIPMENT CO INC
Entity Type:Organization
Organization Name:HOME OXYGEN & EQUIPMENT CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SHURTLEFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-792-8727
Mailing Address - Street 1:8212 ITHACA AVE
Mailing Address - Street 2:STE W10
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-2632
Mailing Address - Country:US
Mailing Address - Phone:806-792-8727
Mailing Address - Fax:806-792-8786
Practice Address - Street 1:8212 ITHACA AVE
Practice Address - Street 2:STE E-G
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423
Practice Address - Country:US
Practice Address - Phone:806-792-8727
Practice Address - Fax:806-792-8786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0034585332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
104059100OtherFIRST CARE
TX086936401Medicaid
509361OtherBCBS
TX015807301Medicaid
509361OtherBCBS