Provider Demographics
NPI:1821030602
Name:HOME OXYGEN SERVICE, LLC
Entity Type:Organization
Organization Name:HOME OXYGEN SERVICE, LLC
Other - Org Name:BEMIS HOME OXYGEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BEMIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-235-2900
Mailing Address - Street 1:129 S CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:KIMBALL
Mailing Address - State:NE
Mailing Address - Zip Code:69145-1256
Mailing Address - Country:US
Mailing Address - Phone:308-235-2900
Mailing Address - Fax:308-235-2901
Practice Address - Street 1:125 S CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:KIMBALL
Practice Address - State:NE
Practice Address - Zip Code:69145-1256
Practice Address - Country:US
Practice Address - Phone:308-235-2900
Practice Address - Fax:308-235-2901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2896332BX2000X, 3336C0003X
333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2817142OtherNCPDP PROVIDER IDENTIFICATION NUMBER
2817142OtherNCPDP PROVIDER IDENTIFICATION NUMBER