Basic Information
| Provider Information | |||||||||
| NPI: | 1346273349 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | AMERICAN OXYGEN AND MEDICAL EQUIPMENT, INC | ||||||||
| LastName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | ARCADIA H.O.M.E. | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26777 CENTRAL PARK BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480764162 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483527530 | ||||||||
| FaxNumber: | 2483525189 | ||||||||
| Practice Location | |||||||||
| Address1: | 381 KAIRNS DR | ||||||||
| Address2: | |||||||||
| City: | CROWN POINT | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463079160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2196630210 | ||||||||
| FaxNumber: | 2196620414 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2006 | ||||||||
| LastUpdateDate: | 08/26/2008 | ||||||||
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| AuthorizedOfficialLastName: | SPARLING | ||||||||
| AuthorizedOfficialFirstName: | CATHY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | VP ADMINISTRATIVE SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 2483527530 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ARCADIA PRODUCTS, INC. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | 0121967549001 | IN | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
ID Information
| ID | Type | State | Issuer | Description | 200528840A | 05 | IN | MEDICAID |