Provider Demographics
NPI:1922083526
Name:SCARBORO OXYGEN SERVICES, INC.
Entity Type:Organization
Organization Name:SCARBORO OXYGEN SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:SCARBORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-554-1945
Mailing Address - Street 1:230 ROSE DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-2930
Mailing Address - Country:US
Mailing Address - Phone:912-554-1945
Mailing Address - Fax:912-554-1945
Practice Address - Street 1:2000 PARKWOOD DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4700
Practice Address - Country:US
Practice Address - Phone:912-554-1945
Practice Address - Fax:912-554-1945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-07
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000836701AMedicaid
GA1265020001Medicare NSC