Provider Demographics
NPI:1659620938
Name:SUMMIT OXYGEN
Entity Type:Organization
Organization Name:SUMMIT OXYGEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LORENZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-209-3190
Mailing Address - Street 1:PO BOX 3123
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59772-3123
Mailing Address - Country:US
Mailing Address - Phone:406-209-3190
Mailing Address - Fax:
Practice Address - Street 1:509 LANDMARK DR
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-7200
Practice Address - Country:US
Practice Address - Phone:406-209-3190
Practice Address - Fax:406-924-6427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-03
Last Update Date:2012-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies