Provider Demographics
NPI:1609827419
Name:EASTERN OXYGEN & MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:EASTERN OXYGEN & MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:GAFFNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-547-8188
Mailing Address - Street 1:818 PROFESSIONAL PL W
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3600
Mailing Address - Country:US
Mailing Address - Phone:757-547-8188
Mailing Address - Fax:757-547-5936
Practice Address - Street 1:818 PROFESSIONAL PL W
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3600
Practice Address - Country:US
Practice Address - Phone:757-547-8188
Practice Address - Fax:757-547-5936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VABN000956332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA066238OtherANTHEM BLUE CROSS BLUE SH
VA0254200001Medicare ID - Type Unspecified