Provider Demographics
NPI:1063511780
Name:OXYGEN PLUS LLC
Entity type:Organization
Organization Name:OXYGEN PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:RCP
Authorized Official - Phone:574-583-4747
Mailing Address - Street 1:PO BOX 152
Mailing Address - Street 2:111 S MAIN STREET
Mailing Address - City:MONTICELLO
Mailing Address - State:IN
Mailing Address - Zip Code:47960-0152
Mailing Address - Country:US
Mailing Address - Phone:574-583-4747
Mailing Address - Fax:
Practice Address - Street 1:111 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:IN
Practice Address - Zip Code:47960-2329
Practice Address - Country:US
Practice Address - Phone:574-583-4747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN314448OtherBLUE CROSS BLUE SHIELD
IN5051070002Medicare ID - Type Unspecified