Provider Demographics
NPI:1770012361
Name:AO2, LLC
Entity Type:Organization
Organization Name:AO2, LLC
Other - Org Name:O2 ASSIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:KARDISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-688-0655
Mailing Address - Street 1:22 RANCHO CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-8325
Mailing Address - Country:US
Mailing Address - Phone:949-688-0566
Mailing Address - Fax:844-271-5766
Practice Address - Street 1:22 RANCHO CIR
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-8325
Practice Address - Country:US
Practice Address - Phone:949-688-0566
Practice Address - Fax:844-271-5766
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AO2, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies