Provider Demographics
NPI:1629001110
Name:OXYGEN THERAPY LLC
Entity Type:Organization
Organization Name:OXYGEN THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:573-426-3000
Mailing Address - Street 1:1040 S BISHOP AVE
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-4416
Mailing Address - Country:US
Mailing Address - Phone:573-426-3000
Mailing Address - Fax:573-426-3582
Practice Address - Street 1:1040 S BISHOP AVE
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-4416
Practice Address - Country:US
Practice Address - Phone:573-426-3000
Practice Address - Fax:573-426-3582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1999137274227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Multi-Specialty