Provider Demographics
NPI:1326114356
Name:COMMUNITY OXYGEN & MEDICAL EQUIPMENT, INC
Entity Type:Organization
Organization Name:COMMUNITY OXYGEN & MEDICAL EQUIPMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:DUVALL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:270-754-3187
Mailing Address - Street 1:PO BOX 431
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42330-0431
Mailing Address - Country:US
Mailing Address - Phone:270-754-3187
Mailing Address - Fax:270-754-3234
Practice Address - Street 1:603 WEST EVERLY BROTHERS BLVD.
Practice Address - Street 2:
Practice Address - City:CENTRAL CITY
Practice Address - State:KY
Practice Address - Zip Code:42330-0431
Practice Address - Country:US
Practice Address - Phone:270-754-3187
Practice Address - Fax:270-754-3234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BP3500X, 335E00000X
KYMG0182332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50120OtherABP PROVIDER NUMBER
KY000000070158OtherBCBS PROVIDER NUMBER
KY1083675OtherPASSPORT PROVIDER NUMBER
KY163570500OtherOWCP PROVIDER NUMBER
KY047309300OtherFEDERAL BLACK LUNG ID #
KY80766OtherNORTHWOOD NPN ID NUMBER
KY90030891Medicaid
KY45903549OtherEPSDT PROVIDER #
KY=========-00OtherGATES MCDONALD ID #
KY45903549OtherEPSDT PROVIDER #