Provider Demographics
NPI:1114031416
Name:ADVANTAGE HOME OXYGEN & RESPIRATORY SERVICES INC
Entity Type:Organization
Organization Name:ADVANTAGE HOME OXYGEN & RESPIRATORY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:PALLONE
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:814-375-7990
Mailing Address - Street 1:PO BOX 276
Mailing Address - Street 2:111 N. BRADY ST
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-0276
Mailing Address - Country:US
Mailing Address - Phone:814-375-7990
Mailing Address - Fax:814-375-2341
Practice Address - Street 1:111 N BRADY ST
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2257
Practice Address - Country:US
Practice Address - Phone:814-375-7990
Practice Address - Fax:814-375-2341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3000007878332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4954120002Medicare NSC