Provider Demographics
NPI:1639108517
Name:OXYGEN QUALIFYING SERVICES
Entity Type:Organization
Organization Name:OXYGEN QUALIFYING SERVICES
Other - Org Name:O2QS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHWEIGHARDT
Authorized Official - Suffix:SR
Authorized Official - Credentials:RRT
Authorized Official - Phone:828-294-0332
Mailing Address - Street 1:1345 SHIREBOURN
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-8264
Mailing Address - Country:US
Mailing Address - Phone:828-294-0332
Mailing Address - Fax:828-294-0144
Practice Address - Street 1:3113 S NC 127 HWY
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-8289
Practice Address - Country:US
Practice Address - Phone:828-294-0332
Practice Address - Fax:828-294-0144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9601509246ZA2600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, MedicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4490743Medicaid
TN4490743Medicaid