Provider Demographics
NPI:1295866481
Name:HOSPITALITY OXYGEN AND MEDICAL EQUIPMENT, LLC
Entity Type:Organization
Organization Name:HOSPITALITY OXYGEN AND MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:HALMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-437-4848
Mailing Address - Street 1:23025 N 15TH AVE
Mailing Address - Street 2:STE 106
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-1409
Mailing Address - Country:US
Mailing Address - Phone:386-437-4848
Mailing Address - Fax:866-623-9456
Practice Address - Street 1:4601 E MOODY BLVD
Practice Address - Street 2:UNIT K11
Practice Address - City:BUNNELL
Practice Address - State:FL
Practice Address - Zip Code:32110-9017
Practice Address - Country:US
Practice Address - Phone:386-437-4848
Practice Address - Fax:866-623-9456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL04549332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL031379300Medicaid
M2783OtherBCBS
FL031379300Medicaid
FL031379300Medicaid