Provider Demographics
NPI:1922062611
Name:OXYGEN PLUS
Entity Type:Organization
Organization Name:OXYGEN PLUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:CATALDO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, RCP
Authorized Official - Phone:269-217-1920
Mailing Address - Street 1:6372 CANTERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49083-8431
Mailing Address - Country:US
Mailing Address - Phone:269-217-1920
Mailing Address - Fax:269-273-6300
Practice Address - Street 1:1120 N MAIN ST
Practice Address - Street 2:
Practice Address - City:THREE RIVERS
Practice Address - State:MI
Practice Address - Zip Code:49093-2379
Practice Address - Country:US
Practice Address - Phone:269-273-5500
Practice Address - Fax:269-273-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4163247Medicaid
MIP107308OtherBCN
MI540C903780OtherBCBSM
MI540C903780OtherBCBSM
MI540C903780OtherBCBSM