Basic Information
| Provider Information | |||||||||
| NPI: | 1871865824 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AIRWAY OXYGEN INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9950 | ||||||||
| Address2: | |||||||||
| City: | WYOMING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 495099918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6162473900 | ||||||||
| FaxNumber: | 6162470776 | ||||||||
| Practice Location | |||||||||
| Address1: | 4120 STADIUM DR | ||||||||
| Address2: | |||||||||
| City: | KALAMAZOO | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490081426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2693721628 | ||||||||
| FaxNumber: | 2693724664 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2012 | ||||||||
| LastUpdateDate: | 08/11/2016 | ||||||||
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| AuthorizedOfficialLastName: | NYHUIS | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
| AuthorizedOfficialMiddleName: | W | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6162473900 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | GRANITE HOLDINGS INC | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332BP3500X | N | Suppliers | Durable Medical Equipment & Medical Supplies | Parenteral & Enteral Nutrition | 332BX2000X | L2096486 | MI | Y | Suppliers | Durable Medical Equipment & Medical Supplies | Oxygen Equipment & Supplies |
No ID Information.