Provider Demographics
NPI:1780601211
Name:AMERICAN OXYGEN AND MEDICAL EQIUPMENT, INC.
Entity type:Organization
Organization Name:AMERICAN OXYGEN AND MEDICAL EQIUPMENT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP ADMINISTRATIVE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPARLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-352-7530
Mailing Address - Street 1:26777 CENTRAL PARK BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-4162
Mailing Address - Country:US
Mailing Address - Phone:248-352-7530
Mailing Address - Fax:248-352-5189
Practice Address - Street 1:111 ERICK ST
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-1305
Practice Address - Country:US
Practice Address - Phone:815-479-9800
Practice Address - Fax:815-479-1354
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARCADIA PRODUCTS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-17
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL34765565332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========004Medicaid
IL=========004Medicaid