Provider Demographics
NPI:1326055591
Name:PREFERRED OXYGEN LLC
Entity Type:Organization
Organization Name:PREFERRED OXYGEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-338-7377
Mailing Address - Street 1:PO BOX 739
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:TN
Mailing Address - Zip Code:37307-0739
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:134 CREEKSIDE DR.
Practice Address - Street 2:SUITE #2
Practice Address - City:OCOEE
Practice Address - State:TN
Practice Address - Zip Code:37361
Practice Address - Country:US
Practice Address - Phone:423-338-7377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN733332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1454255Medicaid
TN40534447OtherBLUECROSS/BLUESHEILD
TN1454255Medicaid