Provider Demographics
NPI:1760629786
Name:AIR EXCHANGE OXYGEN
Entity Type:Organization
Organization Name:AIR EXCHANGE OXYGEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:K
Authorized Official - Last Name:KLOBUCAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-782-6708
Mailing Address - Street 1:35 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-1709
Mailing Address - Country:US
Mailing Address - Phone:406-782-6708
Mailing Address - Fax:406-782-1224
Practice Address - Street 1:35 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1709
Practice Address - Country:US
Practice Address - Phone:406-782-6708
Practice Address - Fax:406-782-1224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT4250820001Medicare NSC