Provider Demographics
NPI:1659544955
Name:OXYGEN RESCUE CARE CENTERS OF AMERICA, LLC
Entity Type:Organization
Organization Name:OXYGEN RESCUE CARE CENTERS OF AMERICA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:HILL
Authorized Official - Last Name:CRALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-819-0412
Mailing Address - Street 1:525 NE 3RD AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-3800
Mailing Address - Country:US
Mailing Address - Phone:561-819-0412
Mailing Address - Fax:561-276-9198
Practice Address - Street 1:525 NE 3RD AVE STE 107
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-3800
Practice Address - Country:US
Practice Address - Phone:561-819-0412
Practice Address - Fax:561-276-9198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6763261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center