Basic Information
Provider Information
NPI: 1487320362
EntityType: 2
ReplacementNPI:  
OrganizationName: OXYGEN ONE, INC
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Mailing Information
Address1: 220 W GERMANTOWN PIKE STE 250
Address2:  
City: PLYMOUTH MEETING
State: PA
PostalCode: 194621437
CountryCode: US
TelephoneNumber: 6106306357
FaxNumber:  
Practice Location
Address1: 3230 UNIVERSITY AVE STE 6
Address2:  
City: MADISON
State: WI
PostalCode: 537053540
CountryCode: US
TelephoneNumber: 4147273100
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/19/2021
LastUpdateDate: 08/19/2021
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: GRIGGS
AuthorizedOfficialFirstName: STEPHEN
AuthorizedOfficialMiddleName: P
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 4072060040
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
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NPICertificationDate: 08/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000X  N SuppliersDurable Medical Equipment & Medical Supplies 
332BC3200X  N SuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
332BP3500X  N SuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
332BX2000X  Y SuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies

No ID Information.


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