Provider Demographics
NPI:1497920417
Name:CROSS OXYGEN DELIVERY,LLC
Entity Type:Organization
Organization Name:CROSS OXYGEN DELIVERY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-839-2904
Mailing Address - Street 1:6111 SUNRAY RD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-6140
Mailing Address - Country:US
Mailing Address - Phone:505-839-2904
Mailing Address - Fax:505-839-2904
Practice Address - Street 1:6111 SUNRAY RD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-6140
Practice Address - Country:US
Practice Address - Phone:505-839-2904
Practice Address - Fax:505-839-2904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMZ7885Medicaid
NMT26GOtherBLUE CROSS BLUE SHEILD OF NEW MEXICO
NMZ7885Medicaid