Provider Demographics
NPI:1871865824
Name:AIRWAY OXYGEN INC
Entity Type:Organization
Organization Name:AIRWAY OXYGEN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:NYHUIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-247-3900
Mailing Address - Street 1:PO BOX 9950
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49509-9918
Mailing Address - Country:US
Mailing Address - Phone:616-247-3900
Mailing Address - Fax:616-247-0776
Practice Address - Street 1:4120 STADIUM DR
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-1426
Practice Address - Country:US
Practice Address - Phone:269-372-1628
Practice Address - Fax:269-372-4664
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRANITE HOLDINGS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-07
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BP3500X
MIL2096486332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition