Provider Demographics
NPI:1215932827
Name:SAULT OXYGEN, INC
Entity type:Organization
Organization Name:SAULT OXYGEN, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BBELLEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-253-1721
Mailing Address - Street 1:PO BOX 832
Mailing Address - Street 2:
Mailing Address - City:SAULT SAINTE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783-0832
Mailing Address - Country:US
Mailing Address - Phone:906-253-1721
Mailing Address - Fax:906-253-1722
Practice Address - Street 1:1122 E EASTERDAY AVE
Practice Address - Street 2:
Practice Address - City:SAULT SAINTE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783-2334
Practice Address - Country:US
Practice Address - Phone:906-253-1721
Practice Address - Fax:906-253-1722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI54O-A702630OtherBLUE CROSS BLUE SHIELD
4274700001Medicare NSC