Provider Demographics
NPI:1114039385
Name:SNF OXYGEN SERVICESLLC
Entity Type:Organization
Organization Name:SNF OXYGEN SERVICESLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GERRY
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:ABACHERLI
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:951-270-5207
Mailing Address - Street 1:1107 FAIR OAKS AVE
Mailing Address - Street 2:STE 528
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-3311
Mailing Address - Country:US
Mailing Address - Phone:951-270-5207
Mailing Address - Fax:951-898-9991
Practice Address - Street 1:240 OTT ST
Practice Address - Street 2:N/A
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-1872
Practice Address - Country:US
Practice Address - Phone:951-270-5207
Practice Address - Fax:951-898-9991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME02250FMedicaid
CADME02250FMedicaid