Provider Demographics
NPI:1306032149
Name:LIFESTYLE OXYGEN, INC.
Entity Type:Organization
Organization Name:LIFESTYLE OXYGEN, INC.
Other - Org Name:LIFESTYLE SLEEP SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:WEILAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-887-5762
Mailing Address - Street 1:2669 UNION LAKE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-3590
Mailing Address - Country:US
Mailing Address - Phone:248-887-5762
Mailing Address - Fax:248-887-3119
Practice Address - Street 1:2669 UNION LAKE RD
Practice Address - Street 2:SUITE C
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-3590
Practice Address - Country:US
Practice Address - Phone:248-887-5762
Practice Address - Fax:248-887-3119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI540F338900OtherBLUE CROSS BLUE SHIELD
MI540F338900OtherBLUE CROSS BLUE SHIELD
MI6010700001Medicare NSC