Provider Demographics
NPI:1376612515
Name:OXIMETRY CO LLC
Entity Type:Organization
Organization Name:OXIMETRY CO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:KATOPODES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-416-2550
Mailing Address - Street 1:15760 19 MILE RD
Mailing Address - Street 2:STE F
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-6319
Mailing Address - Country:US
Mailing Address - Phone:586-416-2550
Mailing Address - Fax:
Practice Address - Street 1:15760 19 MILE RD
Practice Address - Street 2:STE F
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-6319
Practice Address - Country:US
Practice Address - Phone:586-416-2550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
173F00000X, 293D00000X
MI4301046328207RP1001X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care MedicineGroup - Multi-Specialty
No293D00000XLaboratoriesPhysiological LaboratoryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1891765426OtherNPI
PA1497752166OtherNPI
MI4301078992OtherMEDICAL LICENSE
MI1043290232OtherNPI
MI700E002019OtherBLUE CROSS BLUE SHEILD
MI1588664775OtherNPI
MI5101017024OtherSTATE OF MICHIGAN
MI1107410151OtherBLUE CROSS
MI0N60540Medicare ID - Type Unspecified
PA050086EJ8Medicare PIN
MI700E002019OtherBLUE CROSS BLUE SHEILD
MI1043290232OtherNPI
MI1588664775OtherNPI