Provider Demographics
NPI:1780761817
Name:OXYGEN SUPPORT SYSTEMS INC
Entity type:Organization
Organization Name:OXYGEN SUPPORT SYSTEMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:SQUIRES
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-931-1121
Mailing Address - Street 1:PO BOX 845
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-0845
Mailing Address - Country:US
Mailing Address - Phone:856-931-1121
Mailing Address - Fax:856-931-1123
Practice Address - Street 1:153 HARDING AVENUE
Practice Address - Street 2:
Practice Address - City:BELLMAWR
Practice Address - State:NJ
Practice Address - Zip Code:08031-2413
Practice Address - Country:US
Practice Address - Phone:856-931-1121
Practice Address - Fax:856-931-1123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010955730005Medicaid
NJ2947102Medicaid
NJ0268170001Medicare NSC