Provider Demographics
NPI:1891867354
Name:OXYGEN RICH, LLC
Entity Type:Organization
Organization Name:OXYGEN RICH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-223-6930
Mailing Address - Street 1:805 KINGS WAY
Mailing Address - Street 2:
Mailing Address - City:WAKE VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75501-5775
Mailing Address - Country:US
Mailing Address - Phone:903-831-7424
Mailing Address - Fax:903-831-2384
Practice Address - Street 1:805 KINGS WAY
Practice Address - Street 2:
Practice Address - City:WAKE VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75501-5775
Practice Address - Country:US
Practice Address - Phone:903-831-7424
Practice Address - Fax:903-831-2384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0092873332B00000X
TXATP3803332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185354102Medicaid
AR163593716Medicaid
TX185354101Medicaid
TX5847080001Medicare NSC