Provider Demographics
NPI:1376529487
Name:T & S HOME OXYGEN SUPPLY CO
Entity Type:Organization
Organization Name:T & S HOME OXYGEN SUPPLY CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:F
Authorized Official - Last Name:STOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-371-2475
Mailing Address - Street 1:123 OXYGEN DR
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-5790
Mailing Address - Country:US
Mailing Address - Phone:800-371-2475
Mailing Address - Fax:814-371-2169
Practice Address - Street 1:123 OXYGEN DR
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-5790
Practice Address - Country:US
Practice Address - Phone:800-371-2475
Practice Address - Fax:814-371-2169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-20
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1000002513332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011593880001Medicaid
PA044016500OtherFEDERAL BLACK LUNG
PA000283242OtherPA BLUE SHIELD
PA283242OtherHIGHMARK BLUE CROSS
PA000283242OtherPA BLUE SHIELD